• Doctor
  • GP practice

Archived: Lime Square Medical Centre

Overall: Good read more about inspection ratings

Lime Square, Ashton Old Road, Manchester, Lancashire, M11 1DA (0161) 371 0678

Provided and run by:
Lime Square Medical Centre

Latest inspection summary

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Background to this inspection

Updated 13 April 2017

Lime Square Medical Centre is located close to Manchester City centre. The practice is situated in a modern purpose built retail complex. All services are delivered on the first floor of the building with disabled access from the ground floor available. There is multiple parking available to patients.

At the time of our inspection there were 6102 patients registered with the practice. The practice is a member of North Manchester Clinical Commissioning Group (CCG). The practice delivers commissioned services under the General Medical Services (GMS) contract with NHS England.

The male life expectancy for the area is 75 years compared with the CCG averages of 73 years and the national average of 79 years. The female life expectancy for the area is 80 years compared with the CCG averages of 78 years and the national average of 83 years.

The practice is situated in an area at number one on the deprivation scale (the lower the number, the higher the deprivation). People living in more deprived areas tend to have greater need for health services. The majority of patients are white British with the practice seeing an increase in patients of black and minority ethnic group.

The practice has four male GP partners and one part time female salaried GP. There are two practice nurses and one healthcare assistant. Members of clinical staff are supported by a part time practice manager and reception staff.

There have been multiple changes over the nine months prior to our inspection. The practice has employed a permanent practice manager and have recently joined a network of eight other practices. This group forms a support network for clinical and non-clinical staff, where they share ideas, learning, and discuss events.

The practice is open 8am to 6.30pm pm Monday and Friday, Tuesday and Thursday being open 7am to 6.30pm. Every Wednesday the practice opens at 8am and closes at 1pm. The practice is closed daily between 1pm and 2pm. In addition to pre-bookable appointments that can be booked up to four weeks in advance, urgent appointments are available for patients that need them. The practice also offers extended hours and weekend appointments to patients.

Patients requiring a GP outside of normal working hours are advised to call “ Go-to- Doc” using the usual surgery number and the call is re-directed to the out-of-hours service. The surgery also is part of a neighbourhood scheme for Sunday appointments between the hours of 10am and 6pm.

Overall inspection

Good

Updated 13 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lime Square Medical Centre on 7 March 2017. Overall the practice is now rated as good.

The practice had been previously inspected on 31 May 2016. Following this inspection the practice was rated inadequate with the following domain ratings:

Safe – Requires improvement

Effective – Inadequate

Caring – Requires improvement

Responsive – Requires improvement

Well-led – Inadequate

The practice was placed in special measures.

The practice provided us with an action plan detailing how they were going to make the required improvements. In addition, they wrote to us with updates on progress and actions that had been addressed.

Our key findings from the most recent inspection were as follows:

  • Following the inspection on the 31 May 2016, the practice had worked closely with the Northern Health GP Federation, who provided support to the practice by working closely with the clinicians and senior staff to develop improvement solutions and review patient services.
  • The practice had a clear process in place to review, monitor and reduce the quantity of prescribed Hypnotic medicines, which can be addictive.
  • The practice had clearly defined and embedded systems to minimise risks to patient safety. For example, we saw a significant increase in care plans for all vulnerable patients groups.
  • Clinical meetings had been established and we saw evidence of minutes of these meetings.
  • The practice had very recently joined Beacon Medical Group, a cluster of practices which provided a support network for clinical and non-clinical staff.
  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events with learning outcomes documented.
  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment. Staff told us morale was good.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. However, scores relating to waiting times to see the clinicians were low.
  • Information about services and how to complain were available. Improvements were made to the quality of care as a result of complaints and concerns.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvements are:

  • Ensure that confidentiality is maintained in the staffing meeting area and adjacent consulting rooms.
  • Continue to review the waiting times and appointment system action plan, to enhance patient experience of access to services.
  • Revisit the processes in relation to the medication review dates and repeat prescribing policy.

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

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People with long term conditions

Good

Updated 13 April 2017

The practice is rated as good for the care of people with long-term conditions.

  • Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
  • The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
  • All these patients had a named GP and there was a system to recall patients for a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Good

Updated 13 April 2017

The practice is rated as good for the care of families, children and young people.

  • 79% of patients with asthma had an asthma review completed in the preceding 12 months, compared to the CCG average of 75% and national average of 76%.
  • Immunisation rates were relatively high for all standard childhood immunisations.
  • The practice worked with midwives, health visitors and school nurses to support this population group.
  • 76% of eligible women had received a cervical screening test in the preceding five years, compared to the CCG average of 78% and national average of 81%.
  • Appointments were available outside of school hours. Baby changing facilities were available and a room could be made available for women wishing to breast feed their babies.

Older people

Good

Updated 13 April 2017

The practice is rated as good for the care of older people.

  • The practice had identified 2% of patients at higher risk of unplanned admission to hospital, and each of these patients had a care plan in place which was regularly reviewed.
  • Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
  • The practice offered proactive, personalised care to meet the needs of the older patients in its population.
  • The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
  • The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
  • The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

Working age people (including those recently retired and students)

Good

Updated 13 April 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

  • The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours and Saturday appointments.
  • The practice had dedicated Sunday appointments for all working carers.
  • There was additional out of working hour’s access to meet the needs of working age patients with extended opening hours every Tuesday and Thursday open from 7am.
  • The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

People experiencing poor mental health (including people with dementia)

Good

Updated 13 April 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

  • The practice carried out advance care planning for patients living with dementia.
  • 78% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, compared to the CCG average 87% and the national average of 84%. Increase of 48 % from the previous inspection.
  • The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
  • Patients at risk of dementia were identified and offered an assessment.
  • The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
  • The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

People whose circumstances may make them vulnerable

Good

Updated 13 April 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

  • The practice held a register of patients living in vulnerable circumstances including those with a learning disability.
  • End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
  • The practice offered longer appointments for patients with a learning disability and provide home visits for reviews where required.
  • The practice regularly worked with other health care professionals in the case management of vulnerable patients.
  • The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
  • Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.