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Inspection Summary


Overall summary & rating

Good

Updated 27 November 2017

Letter from the Chief Inspector of General Practice

We carried out an unannounced focused inspection at The Lime Tree Surgery on 6 October 2017 in response to concerns raised directly with CQC. This related to patient access to services, quality of treatment, appropriate standards of cleanliness and hygiene and confidentiality of patient identifiable information. This report covers our findings in relation to the inspection on 6 October 2017. As a result of this inspection the provider’s rating remains unchanged and stays as Good.

Our key findings were as follows:

  • The practice had experienced a period of change following a recent merger.

  • We found the premises to be clean, tidy and in generally good repair both inside and out.

  • Staff demonstrated an understanding of the importance of patient confidentiality.

  • We found that the practice had taken positive steps to improve access to appointments and patients and staff told us access to appointments had improved.

  • Although lessons were learned from individual concerns and complaints, there was not sufficient communication about complaint outcomes between the practice management team.

However, there was one area of practice where the provider should make improvements.

The provider should:

  • Improve communication in relation to complaint outcomes between the practice management team and clinical staff.

  • Consider including the nursing team in clinical meetings, significant events meetings and complaints meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 27 November 2017

At our previous focused inspection on 26 May 2017, we rated the practice as Good for providing safe services. At this unannounced focused inspection this rating remains unchanged.

We received a concern relating to the cleanliness of the Lime Tree Avenue site.

At this inspection we found the premises to be clean and tidy both inside and out.

Effective

Good

Updated 18 April 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average for the locality and compared to the national average.

  • Staff assessed needs and delivered care in line with current evidence based guidance.

  • Clinical audits demonstrated quality improvement.

  • Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • Staff worked with multidisciplinary teams to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 27 November 2017

At our previous comprehensive inspection on 4 February 2016, we rated the practice as Good for providing caring services. At this unannounced focused inspection this rating remains unchanged.

We received a concern relating to patient identifiable information which was left on the reception desk in view of patients and staff entering clinic rooms during patient consultations.

During this inspection, we observed staff at reception to be considerate of patient confidentiality.

Responsive

Good

Updated 27 November 2017

At our previous comprehensive inspection on 4 February 2016, we rated the practice as Good for providing responsive services. At this unannounced focused inspection this rating remains unchanged.

We received three concerns relating to access to appointments including difficulty accessing urgent appointments, phone calls from a GP and home visits. We reviewed the complaints received by the practice between May 2017 and the date of our inspection.

At this inspection we found that the practice had taken positive steps to resolve the concerns raised and patients and staff told us access to appointments had improved.

Although lessons were learned from individual concerns and complaints there was not sufficient communication about complaint outcomes between the practice management team.

Well-led

Good

Updated 27 November 2017

At our previous focused inspection on 11 October 2016, we rated the practice as Good for providing well-led services. At this unannounced focused inspection this rating remains unchanged.

We received three concerns about bullying at the practice.

We discussed this with the practice management team, the nursing team and reception and administration staff. We were told that while there had been some issues during the period of change at the practice, these had been resolved and staff told us they were not currently aware of any bullying within the practice.

Checks on specific services

People with long term conditions

Good

Updated 22 June 2017

The provider had resolved the concerns for safety

identified at our inspection on

11 October 2016

which applied to everyone

using this practice, including this population group. The population group

ratings remain good.

Families, children and young people

Good

Updated 22 June 2017

The provider had resolved the concerns for safety

identified at our inspection on

11 October 2016

which applied to everyone

using this practice, including this population group. The population group

ratings remain good.

Older people

Good

Updated 22 June 2017

The provider had resolved the concerns for safety

identified at our inspection on

11 October 2016

which applied to everyone

using this practice, including this population group. The population group

ratings remain good.

Working age people (including those recently retired and students)

Good

Updated 22 June 2017

The provider had resolved the concerns for safety

identified at our inspection on

11 October 2016

which applied to everyone

using this practice, including this population group. The population group

ratings remain good.

People experiencing poor mental health (including people with dementia)

Good

Updated 22 June 2017

The provider had resolved the concerns for safety

identified at our inspection on

11 October 2016

which applied to everyone

using this practice, including this population group. The population group

ratings remain good.

People whose circumstances may make them vulnerable

Good

Updated 22 June 2017

The provider had resolved the concerns for safety

identified at our inspection on

11 October 2016

which applied to everyone

using this practice, including this population group. The population group

ratings remain good.