Archived: Dr Samuel Levenson Also known as Limefield Medical Centre

Updated 3 October 2016

Limefield Medical Practice is located in Salford. The address of the practice is 6-8 Limfield Road, Salford, M7 4LZ. The practice has some parking facilities at the rear of the building and has good public transport links with bus stops nearby.

The practice is a single handed practice with a male GP, two practice nurses (female), a practice pharmacist, a practice manager, and a team of reception staff. The practice uses a regular locum GP.

The practice is open and offered appointments between 8am and 6.30pm Monday to Thursday. On a Friday the practice is open from 8am to 2pm in the winter and 8am to 3pm in the summer. Extended hours appointments are offered 6.30pm to 8.45pm on a Wednesday evening. In addition to pre-bookable appointments that can be booked up to six weeks in advance, urgent appointments are also available for people that needed them.

Outside of opening hours, patients are directed to the NHS 111 out of hour’s service.

The practice has approximately 5000 patients and operates under a general medical services (GMS) contract and is part of NHS Salford Clinical Commissioning Group. The practice is in an area of Salford that homes a large population of orthodox Jewish. The practice has an above average of working age people and infants compared to the national average.

Updated 3 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Limefield Medical Centre

on 11 August 2016. Overall the practice is rated as requires improvement.

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

• There was an open and transparent approach to safety.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, there were examples of incidents not being documented.
• Data showed patient outcomes were low compared to the national average.
• The practice had a number of policies and procedures to govern activity, but some were overdue a review.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• 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 and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• Ensure that there are robust governance arrangements in place so that risks are identidied and managed effectively and ensure all staff are aware of what constitutes as a significant event so that these can be documented correctly.
• The practice needs to ensure that clinical staff are involved in clinical audits.

• The provider must ensure that patient identifiable medical information is securely maintained at all times.
• The provider must ensure all staff have an appraisal, medical indemnity insurance, and that all staff have training relevant to their role including basic life support and safeguarding.

The areas where the provider should make improvement are:

• Consider improving access to emergency medicines so they are accessible to all staff.
• Consider keeping all clinical rooms locked when left unattended.
• Improve record keeping in the practice and consider the need to document daily checks.
• Consider the need for a training spreadsheet/matrix to monitor and identify gaps in staff training.
• Review the PGD (patient group direction) folder to ensure all are signed correctly.
• Review practice policies to ensure they are all up to date and contain the necessary information.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 October 2016

The practice is rated as requires improvement for the care of people with long-term conditions. This is because the provider was rated as requires improvement overall. The concerns which led to those ratings apply to everyone using the practice, including this population group.

However, there were examples of good practice:

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 3 October 2016

The practice is rated as requires improvement for the care of families, children and young people. This is because the provider was rated as requires improvement overall. The concerns which led to those ratings apply to everyone using the practice, including this population group.

However, there were examples of good practice:

• Immunisation rates for the standard childhood immunisations were mixed compared to the local and national average.
• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 3 October 2016

The practice is rated as requires improvement for the care of older people. This is because the provider was rated as requires improvement overall. The concerns which led to those ratings apply to everyone using the practice, including this population group.

However, there were examples of good practice:

• The practice offered proactive, personalised care to meet the needs of this patient population group.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 3 October 2016

The practice is rated as requires improvement for the care of working age people (including those recently retired and students). This is because the provider was rated as requires improvement overall. The concerns which led to those ratings apply to everyone using the practice, including this population group.

However, there were examples of good practice:

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 3 October 2016

The practice is rated as requires improvement for the care of people experiencing poor mental health (including people with dementia). This is because the provider was rated as requires improvement overall. The concerns which led to those ratings apply to everyone using the practice, including this population group.

However, there were examples of good practice:

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice would follow up on patients who had attended accident and emergency if they may have been experiencing poor mental health as instructed by the hospital.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• However, only 75% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is below the national average.

Updated 3 October 2016

The practice is rated as requires improvement for the care of people whose circumstances may make them vulnerable This is because the provider was rated as requires improvement overall. The concerns which led to those ratings apply to everyone using the practice, including this population group.

However, there were examples of good practice:

• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours but not all staff had the correct level of safeguarding training.