The Limes Medical Centre

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. We found the practice treated people including their staff with kindness and respect. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. They were patient centred and treated people as individuals; however, there were improvements required to ensure this was applied consistently in the practice. People did not always feel they had choice and control over their own care, treatment and wellbeing. Their immediate needs were not always responded to.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice strived to treat people with kindness, compassion and dignity. Staff treated colleagues and those from other organisations with kindness and respect. When we carried out the site visits on inspection, we observed happy and motivated staff. Staff we spoke to were responsive and welcoming to the inspection team. We observed front line staff treat patients and their colleagues with kindness and respect.

We also saw evidence of the practice going above and beyond for their extremely unwell patients; for example, one of the GPs would accompany their complex patients to their consultant appointments.

The practice participated in the PCN’s workforce wellbeing survey carried out in February 2024 and completed by 44 staff. Some of the results showed that most staff agreed with the practice culture of kindness. For example, 42 out of 44 staff felt people they worked with were kind and understanding to one another and 39 staff felt people they worked with showed appreciation to one another, whilst 5 neither agreed nor disagreed. Prior to the inspection, we sent feedback forms to every individual staff member and we received 21 responses back which all praised the culture of kindness and support in the practice.

Feedback we received from care homes showed all the care homes felt they had a good working relationship with the GP service, who were responsive and excellent in maintaining their residents’ privacy and dignity.

Arrangements were in place to promote patients’ privacy and we saw evidence of staff protecting patient confidentiality. All the clinical rooms at all 4 sites had privacy curtains for patients. Breastfeeding facilities were available at most of the practice sites.

However, the 2024 National GP Patient Survey available at the time of inspection showed the practice was a negative outlier in all the relevant 5 indicators. The data showed that 75% of patients felt the healthcare professional were very good or fairly good at treating them with care and concern; however, this was lower than the national average of 85%. The practice was aware of the low patient satisfaction scores from the national survey and stated that they were in the bottom 10% of patient surveys; however, this had been the case for a very long time. Feedback received from the integrated care board (ICB) showed the practice was below the ICB average although they had improved on their scores from 2023.

Following the inspection and action implemented by the practice, we compared the data from the 2024 National GP Patient Survey to the now available 2025 data and found significant improvement in patient satisfaction scores, with a similar cohort of patients. 88% of patients felt the healthcare professional were very good or fairly good at treating them with care and concern and this was an improvement from 75% from the 2024 data and higher than the local average of 85% and national average of 86%. This data suggested the action plan implemented by the practice was having a positive impact on patient satisfaction.

The practice reviewed all their feedback, including that from online NHS reviews and the 2024 National GP patient survey and we found evidence of survey analysis and an action plan was put in place to address the areas of low patient satisfaction. For example, implementation of AI to increase time focusing on patient rather than the computer. They had an active and well engaged Patient Participation Group (PPG) of 600 virtual members, set up to share new ideas, as well as discuss positive and constructive feedback, including these survey results through meetings and engagement events.

The practice also provided monthly feedback from patients dating between May 2024 to May 2025, where patients mostly praised the practice for kind, helpful and caring staff. The practice provided us with results from NHS reviews which were mostly positive but also contained negative feedback where patients were not happy with the service provided. We saw the management of the practice engaged with patient feedback and responded to all patients comments on NHS reviews.

We spoke to 5 patients during our inspection who told us they felt their dignity was always respected and they were treated with kindness and compassion by staff and most of the staff were helpful. However, some of the patients did not find some of the reception staff attitude particularly helpful and this was consistent with some of the reviews shared on NHS webpages online, where some patients raised concerns with some frontline staff attitude. This was consistent with the 2024 National GP Patient Survey which showed 70% of patients found the receptionists at the practice helpful and this was lower than the local average of 81% and national average of 83%.

The practice completed an action plan to restructure the administration and reception team to allow them to focus entirely on dealing with patients. Action implemented also included the recruitment of additional staff and the introduction of customer service training.

Following the inspection and action implemented by the practice, we compared the data from the 2024 National GP Patient Survey to the now available 2025 data and found significant improvement in patient satisfaction scores, with a similar cohort of patients. 79% of patients found the receptionists at the practice helpful and this was an improvement from 70% from the 2024 data and was comparable to the local and national average. This data suggested the action plan implemented by the practice was having an impact on patient satisfaction.

Patients were also notified of the CQC inspection and were invited to send their feedback to CQC, in addition to other feedback sent to CQC. Positive feedback received praised kind, helpful and supportive staff who went the extra mile for their patients; however, negative feedback highlighted issues with the care provided and staff attitude.

The practice was patient centred and treated people as individuals; however, there were improvements required to ensure this was applied consistently in the practice, as we found staff did not always involve people in decisions about their care and treatment. The 2024 National GP Patient Survey showed that 86% of patients felt they were involved as much as they wanted to be in decisions about their care and treatment, slightly lower than the national average. However, data from the 2025 survey showed this had improved to 90%, which was comparable with the local and national averages.

When we looked at patient feedback, we found the patient experience of the service as indicated in the 2024 National GP Patient Survey showed that 80% of patients felt that during their last appointment, the healthcare professional was fairly good or good at listening to them, which was slightly below the national average.

Some of the patients expressed that they did not always feel listened to when communicating with front line staff.

There was an equality and diversity policy; however, this was more employee specific and did not refer to patients. Training records showed staff had received their annual equality and diversity training but we found 3 staff were overdue this training and it had not been recorded as mandatory training for 5 of their sessional GPs.

Patient feedback submitted by the practice showed several instances of when patients were treated as individuals. However, this feedback was mixed as patient complaints sent to the practice showed not all patients felt they were treated as individuals. The practice did not receive any complaints or negative feedback related to discrimination or not observing people's human rights.

Feedback from the 8 care homes looked after by the practice was positive as they told us the GPs would carry out phone and video calls with the residents and their next of kin if they had no capacity, to ensure the residents were involved in their care as much as possible and some felt the practice was the most responsive and would act on their requests.

The service promoted people’s independence, so people knew their rights; however, they did not always feel they had choice and control over their own care, treatment and wellbeing. Staff told us patients were supported to have choice and control over their own care and to make decisions about their care, treatment and wellbeing. For example, when annual reviews were due, they told us patients had the choice to have either face to face or virtual appointments. Patients attending mental health reviews were offered longer appointments. We also received feedback where patients and their families felt their loved ones dying wishes were honoured.

Staff helped patients and their carers to access advocacy and community-based services. For example, they had 2 social prescribers employed on behalf of their Primary Care Network (PCN) who were engaged in supporting older people to access additional support and to signpost them to other services such as the blue badge scheme, befriending service, voluntary support networks and benefits. The practice website offered patients access to different local services and a variety of links to access services such as, self-referrals to physiotherapy, counselling and links to a variety of wellbeing services.

As part of the inspection, we sought patient views and spoke to patients onsite and received mixed feedback. For example, positive patient feedback praised the social prescribers in the practice, whereby patients felt they were knowledgeable and maintained regular contact with them, as well as giving them information about support groups and organisations. Patients also told us they received good advice from the GP regarding signposting to mental health charities and most of the patients we spoke to were happy that they were able to discuss more than one issue in one appointment and were offered double appointments where needed. We saw examples of negative feedback relating to patients not being able to see a GP of their choice and felt there was no continuity as a result.

We also received mostly positive feedback from the 8 care homes looked after by the practice. Care home staff welcomed visits from the practice’s dedicated extended care practitioner (ECP) team who used a practice vehicle to undertake care home visits and visits to housebound elderly patients across the week. Care home staff felt this team was knowledgeable; however, they did not always feel they had a choice in seeing a GP face to face when requested.

They also told us the GPs carried out video calls with the residents every 28 days; however, feedback from one of the care homes stated that they had to prompt these video calls to ensure their residents were seen. This had an impact on patient care as they in turn would become more reliant on acute services like the ambulance and hospital. Most of the care homes told us their residents would like to see their GP in person monthly, as video calls would sometimes confuse them. Care home face to face visit requests were reviewed by an extended care practitioner or GP who would conduct a face to face visit where it was clinically appropriate following clinical triage.

Feedback from the 8 care homes was largely positive, with most describing the practice as responsive and proactive in supporting residents to remain at home. Care home staff praised the practice’s efforts to maintain continuity of care and address residents’ needs promptly.

However, some homes reported challenges, including limited opportunities for face-to-face GP consultations and reliance on Zoom for multidisciplinary team (MDT) meetings, which they felt reduced the depth of discussion and personal connection compared to in-person meetings. In addition, MDT sessions were occasionally cancelled due to training afternoons without alternative dates offered, limiting opportunities to address residents’ medical needs. Despite these concerns, care homes noted that the practice remained more responsive than other local GP surgeries and that doctors were proactive in helping residents avoid hospital admissions.

Our findings were consistent with this feedback. While Extended Care Practitioners (ECPs) and the Rapid Intervention Service (RIS) team provided face-to-face visits, 3 of the 7 residents expressed concerns about reduced GP home visits. Some residents experienced confusion and difficulty engaging with video calls, which impacted their sense of choice and control over care. These issues were discussed at the practice’s clinical governance meeting; however, further consideration was required to ensure patient needs and preferences are considered and acted on.

The service listened to and understood people’s needs, views and wishes but this was not always consistent with patient feedback.When we looked at the processes in place we found there was a system for appointment triage that ensured people with immediate needs had access to services. The practice had a duty team consisting of the duty doctor who triaged the appointment requests. There was a home visit policy to triage visit requests and they prioritised home visits for housebound, terminally ill patients and other eligible criteria. Patients could also request double appointments where required and some nurse appointments were doubled. Most of the patients we spoke to on the day told us clinicians were accommodating to more than 1 condition during their appointments.

When patients were discharged from hospital, the clinical pharmacist reviewed the discharge summaries and ensured the medicines were aligned and updated. Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams.

We were not assured that there was sufficient clinical supervision and oversight to ensure nursing staff who assessed suicide risk in patients were competent to do so. There were systems in place to refer such patients to the crisis team and to a duty doctor and the practice showed evidence of an inhouse session on assessing suicide risk facilitated by a consultant psychiatrist. However, we were not assured there was effective clinical oversight to ensure staff undertaking this role had the competencies to do so.

Where the practice had failed to respond to people’s immediate needs, we saw evidence from the 5 patient complaints we reviewed that they acknowledged when their response had fallen short of the expected standards and actions taken to ensure their ongoing needs were met.

However, we received significantly mixed patient feedback from different channels including feedback sent directly to CQC, online patient surveys and feedback, as well as complaints and compliments sent directly to the practice. People praised how the practice responded to their immediate needs and acted to minimise any discomfort, concern or distress and we saw examples of this. For example, patients told us their blood tests and scans were arranged promptly and their immediate needs were taken care of. Some patients said they had never had a negative experience at the surgery.

We saw examples of how the practice acted promptly to address acute care needs inside the practice. However, other patients told us that they did not always receive the immediate care and treatment when needed; for example, some patients told us their cardiac symptoms were not immediately addressed despite assurances by the practice of a GP callback. One patient told us their urgent and acute symptoms indicating an arthritic condition were dismissed by a clinician and later diagnosed privately, causing unnecessary suffering. In both these cases where concerns were raised, we were not satisfied the practice had sufficiently addressed these concerns to ensure the patient needs had been met.

We also received concerns that a young child had been redirected to out of hours service who redirected them back to the practice as it was open, leading to delayed treatment for the patient.

The 2024 GP patient survey data showed that 88% of patients felt their needs were met when compared to the local and national averages of 90%. The practice reviewed these survey results and told us the practice had an open-door approach to patients and feedback was regularly reviewed and audited to identify trends and themes. The feedback was then passed onto the relevant teams and actions taken to improve where required.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. Prior to our inspection, we sent out voluntary staff feedback forms which gave them the opportunity to confidentially feedback their experiences of working at the practice. We received a total of 21 responses out of the 71 staff feedback forms we sent out to staff and we analysed the responses provided. Staff praised their colleagues and management staff and told us they were valued by leaders who offered a supportive teaching and learning environment. We also saw practice support for staff who were on accreditation courses. We spoke to at least 20 staff over the 3 days of inspection whose feedback was consistent with the positive staff feedback form results.

We did not receive any concerns regarding working conditions at the practice. Staff told us they generally enjoyed working at the service. Some staff reported that the reception area could become uncomfortably hot at times, although it was unclear whether this had been formally raised. There was no evidence to suggest that management would fail to address such issues, as leaders demonstrated a clear commitment to staff safety and wellbeing.

Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as regular breaks and rest areas. Staff also had access to private medical cover and those returning from long-term absence such as maternity leave felt supported and protected by the team. For example, they gave us examples where they were allocated a private space to meet the nutritional needs of their babies, which helped ease their transition back to work and enabled their wellbeing. Staff with caring responsibilities or unique personal situations where flexibility was required also felt supported by the provider. We also found staff requiring bereavement support received mental health support from the practice.

There was a staff newsletter with staff updates, competitions, a 60-second interview with a designated staff member to know more about them and recognised birthday celebrations and staff told us this made them feel more like a team. Staff also reported being supported if they were struggling at work and we also saw evidence of staff promotion to higher roles within the practice. Team building days were established within the practice and staff enjoyed organising these events, which included horse racing, bowling or darts. A staff suggestion box was reviewed by the managers every month and we also saw complimentary feedback the practice had received from 6 of their pharmacy-based colleagues.

The practice also carried out ‘you said, we did’ staff surveys for their staff and we saw evidence of their suggestions being taken on board; for example, installation of lights in their staff car park and non-clinical staff suggested an update of their uniform blouses. The provider sent staff a link where they could select their preferred style and colour and when we carried out the site visit, we observed non-clinical staff wearing smart uniforms which also reflected their different roles. Staff feedback highlighted a strong culture of stability and satisfaction, with most team members having served at the practice for 10 to 30 years.