The Care Quality Commission
  • 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

All Inspections

7 March 2017

During a routine inspection

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

31 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lime Square Medical Centre on 31 May 2016. Overall the practice is rated as Inadequate.

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

  • Patients were at risk of harm because systems and processes were not fully embedded to keep them safe. For example no care plans were in place for vulnerable patients and there was no clinical meetings in place.
  • The practice had no clear leadership structure, insufficient leadership capacity and limited formal governance arrangements.
  • Patient outcomes were hard to identify as little reference was made to audits or quality improvement and there was no evidence that the practice was comparing its performance to others; either locally or nationally.
  • Patients were positive about their interactions with staff and said they were treated with compassion and dignity.
  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.

The areas where the provider must make improvement are:

  • The provider must undertake patient care planning quality improvements. For example a more effective focus on hospital admissions and discharges, mental health, learning disability and palliative care patients.
  • Ensure patients on high risk medications such as hypnotics are properly monitored and reviewed.
  • Introduce a system to ensure all staff receive patient safety alerts and any action required is clearly identified and completed.
  • Ensure Patient Specific Directions (PSD) are introduced to support the healthcare assistant where they are giving injections.
  • Maintain and monitor the quality assurance processes for reporting, recording, acting on and monitoring of significant events.

The areas where the provider should make improvement are:

  • Maintain the new governance systems to ensure integrated fully into the practice.
  • Review the management support to ensure new processes are embedded and monitored to ensure safety of patients and staff, and the smooth running of the practice.
  • Identified carers and review the support the practice could provide to further support carers.
  • Develop a clear vision and practice plan to ensure good outcomes for patients.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice