This practice is rated as Good overall. (Previous inspection 10 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Lime Tree and Sinnott Healthcare on 12 March 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• There was evidence of quality improvement and the practice made good use of clinical audits.
• Clinical guidelines and patient safety alerts were discussed in clinical meetings where learning was shared.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice had clear systems for acting on responding to and learning from complaints.
• There was a strong focus on continuous learning and improvement at all levels of the organisation, all staff had completed mandatory training and were given the minimum of one afternoon a month protected time to keep up to date.

The areas where the provider should make improvements are:

• Ensure systems are in place to label all clinical waste bags.
• Continue to review the system for reviewing patient pathology results.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lime Tree and Sinnot Practice on 20 October 2015. Overall the practice is rated as good.Our key findings across all the areas we inspected were as follows:

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The lead for Infection Prevention and Control did not have sufficient training or a thorough understanding of the role.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they were able to get an appointment when they needed one and urgent appointments available the same day, but found it difficult getting through to the practice by telephone.
• The practice had good facilities and was 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.
• Results from the national GP patient survey showed patients felt they were treated with compassion, dignity and respect. The practice was above average for its satisfaction scores on consultations with doctors and nurses

However there were areas of practice where the provider needs to make improvements.

Importantly the provider must:

• Ensure that Patient Group Directives are signed by the GP as well as the practice nurse.

• Ensure that the Infection Control lead carries out infection control training toenable them to carry out their infection prevention and control lead role.

In addition, the provider should:

• Review its significant events reporting and recording systems to ensure they are being systematically identified and shared with relevant staff; and used to identify risks and continuously improve patient safety.

• Ensure a system is put in place for acting on national patient safety alerts.

• Provide chaperone training for the practice’s only male member of staff so that male patients have the choice of using a male chaperone.

• Display posters advising patients’ that chaperones were available.

• Ensure all practice policies and protocols are in date and version controlled.

• Make it apparent to patients about how to access a male GP.

Letter from the Chief Inspector of General Practice

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice