Background to this inspection
Updated
6 February 2020
The Limes Medical Centre is located in the Small Heath area of Birmingham within the Birmingham and Solihull (BSol) Clinical Commissioning Group (CCG) and provides services to 6,693 patients under the terms of a General medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.
Services are provided from a main surgery located in the Small Heath area of Birmingham and from a branch surgery, Finch Road Primary Care Centre, Finch Road, Lozells, Birmingham.
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury. These are delivered from both sites.
We did not visit the branch surgery as part of this inspection, but we did sample information from there that was relevant to out inspection, such as risk assessments, information about medicines management and complaints. The main surgery was purpose built in 1997 and is accessible by public transport. Car parking is available on site and all patient services are provided from the ground floor.
The clinical team is comprised of three GP partners (one male, two female), one salaried GP (male), and four locum GPs (three male and one female) and three practice nurses. The clinical team is supported by a practice manager and a team of seven receptionists and two administrators one of whom also fulfils the role of the practice Health Care Assistant (HCA).
The practice opens between 8.30am and 6.30pm on Monday to Friday. GP consulting times on Mondays to Wednesday and Friday are from 9.30am to 1pm and from 4.30pm to 6.30pm. Consulting times for Thursday are from 9.30am to 1pm, at which time the practice has a rota of on-call doctors available. The practice also provides additional access to their patients at local hub sites through the federation. These are each week day from 8am to 8pm and on a Saturday from 9am until noon.
The National General Practice Profile states that 83.4% of the practice population is from black, mixed or other non-white ethnic groups. Information published by Public Health England, rates the level of deprivation within the practice population group as one, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.
Updated
6 February 2020
We carried out an announced comprehensive inspection at The Limes Medical Centre on 13 December 2019. We decided to undertake an inspection of this service following our annual review of the information available to us. This inspection looked at the following key questions:
- Safe
- Effective
- Caring
- Responsive
- Well-led
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as good overall and good for all population groups, with the exception of the “working age” and “families, children and young people” population groups.
We rated the practice as requires improvement for providing effective services because;
- The practice performed well in benchmarking results (QOF) in all areas except for childhood immunisations and cancer screening. In relation to childhood immunisations, the practice was unable to fully demonstrate that sufficient improvements had been made. In relation to cancer screening, the practice had taken action to address these. Although bowel cancer screening had improved, the practice could not yet demonstrate that breast and cervical screening uptake had improved. Following the inspection, the practice provided some unverified data that suggested that cervical screening was beginning to improve but was still below target.
We rated the practice as Good for providing safe, caring, responsive and well-led services because;
- The practice had well established systems to keep patients safe from avoidable harm and safeguard them from abuse and improper treatment. The practice had a suite of risk assessments that were appropriately and meaningfully utilised to improve outcomes for patients.
- Patient satisfaction on the national GP patient survey was lower than averages in a number of areas. The practice demonstrated that they had taken action to address these, for example, providing guidance for and facilitating discussions on consultation styles and providing training to ensure patients’ needs were met. The practice in-house survey demonstrated that patient satisfaction was improving.
- In relation to access to care and treatment, the practice had taken a number of actions, including employing extra staff and putting in extra telephone lines and were able to demonstrate that patient satisfaction had improved as a result.
- The practice leadership demonstrated the capacity and capability to provide high quality care and deliver appropriate services to their population group. They were visible and had a clear strategy to ensure that outcomes for patients continued to improve.
Whilst we found no breaches of regulations, the provider should:
- Ensure that all risks relating to ongoing DBS checks have been considered.
- Establish a formal system of supervision for non-medical prescribers.
- Continue to ensure that improvements are made to cancer screening uptake figures.
- Continue to ensure that improvements are made to childhood immunisation uptake figures.
- Continue to ensure that patient satisfaction improves, with regular reviews.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care