Berry Lane Medical Centre

Updated 18 January 2017

Berry Lane Medical Centre is based in in the heart of the Ribble Valley in Longridge which is semi-rural in nature, and therefore looks after patients from rural communities in addition to the residents of Longridge town. There were 10,122 patients on the practice register at the time of our inspection.

The practice is a teaching and training practice managed by four GP partners (two male, two female) and there is one salaried GP. There is a nurse practitioner, two practice nurses, two treatment room nurses, a nursing home specialist nurse and a healthcare assistant. Members of clinical staff are supported by a practice manager, reception and administration staff.

The practice is open 8am to 6.30pm every weekday. The practice is also open on a Saturday and Sunday morning 8am to 11am. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service by calling 111.

The practice has a Personal Medical Services (PMS) contract and has enhanced services contracts which include childhood vaccinations. The practice is part of NHS Greater Preston Clinical Commissioning Group.

Updated 18 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Berry Lane Medical Centre on 1 December 2016. Overall the practice is rated as good and outstanding for providing responsive services. Our key findings across all the areas we inspected were as follows:

• The practice is situated in a purpose built health centre. The practice was clean and had good facilities including disabled access, translation services and a hearing loop.
• There were systems in place to mitigate safety risks including analysing significant events.
• The practice was aware of and had systems in place to ensure compliance with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).
• Patients’ needs were assessed and care was planned and delivered in line with current legislation.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Results from the national GP patient survey showed that patient satisfaction was above local and national averages in all aspects of delivery of care.
• Information about services and how to complain was available. The practice sought patient views about improvements that could be made to the service.
• Staff worked well together as a team and all felt supported to carry out their roles. There was a low turnover of staff and all staff we spoke with appreciated the open culture of the practice and that they felt valued in their work and were treated as equals.

There were outstanding elements of practice including:

• The practice had identified the need for a full time nursing and residential home specialist nurse to avoid unnecessary hospital admissions and plan for good end of life care. This ensured a continuity of care for patients and support for their families. The practice specialist nurse had formulated a ‘stay at home template’ only for patients with DNARs in place that was signed by the patient where possible, carer, out of hours and the relevant GP to avoid any GP sending a patient unnecessarily to hospital unless the patient had experienced trauma.
• In addition, the practice specialist nurse had provided educational sessions for care homes. For example, advice on keeping elderly patients hydrated to avoid medical problems.
• The practice provided a minor injuries service responding to the needs of local farm workers and they had responded to the needs of patients in their rural setting by being open seven days a week.
• The practice acted on innovative suggestions from staff. For example, as a result of one member of staff’s suggestion, the practice had produced an induction pack for medical students which were sent to them prior to them attending the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 January 2017

The practice is rated as good for providing services for people with long term conditions. The practice had registers in place for all long term conditions including diabetes and asthma. Longer appointments and home visits were available when needed. All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Patients on warfarin medication could have their tests carried out at the practice to reduce the need for hospital visits. 

Updated 18 January 2017

The practice is rated as good for providing services for families, children and young people. The practice operated a personal list system, enabling whole families to be registered with the same GP providing continuity of care.

The practice regularly liaised with health visitors to review vulnerable children and new mothers.

The practice had an emergency clinic so children could be seen on the same day if necessary. There was a designated children’s play area in the waiting room.

Updated 18 January 2017

The practice is rated as good for providing services for older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and offered home visits and care home visits.

The practice had identified the need for a full time nursing and residential home specialist nurse to avoid unnecessary hospital admissions and plan for good end of life care. This ensured a continuity of care for patients and support for their families. The practice specialist nurse had formulated a ‘stay at home template’ only for patients with DNARs in place that was signed by the patient where possible, carer, out of hours and the relevant GP to avoid any GP sending a patient unnecessarily to hospital unless the patient had experienced trauma.

The practice participated in meetings with other healthcare professionals to discuss any concerns.

Updated 18 January 2017

The practice is as rated good for providing services for working age people. The needs of this population group had been identified and the practice had adjusted the services it offered to ensure these were accessible. There were online systems available to allow patients to make appointments.

The practice runs a Saturday and Sunday morning clinic, for ease of access. The emergency surgery has the capacity to act as an overspill clinic and means that people who work can be seen on the same day.

The practice had a minor injuries service which was used by farm workers as they were a group which was particularly prone to injuries which can be managed in a primary care setting rather than having to make a journey into Preston.

Updated 18 January 2017

The practice is rated as good for providing services for people experiencing poor mental health. Patients experiencing poor mental health received an invitation for an annual physical health check. Those that did not attend had alerts placed on their records so they could be reviewed opportunistically.  All staff had received training for dementia awareness and the Mental Capacity Act.

The practice provided care for patients at two Lancashire County Council special needs children’s and young person’s homes.

Updated 18 January 2017

The practice is rated as good for providing services for people whose circumstances make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had carried out annual health checks and longer appointments were available for people with a learning disability. 

The practice was one of two practices that provided care and end of life care, for patients at a local community hospital.