Leela Ltd Also known as The Strand Medical Centre

Updated 28 October 2016

Leela Ltd provides primary medical services in Rochdale from Monday to Friday. The practice is open between 9am and 6pm Wednesday to Friday and until 7.15pm every Monday evening and until 7.30pm every Tuesday evening. Appointments with a GP are available between 9am and 11am and between 3.30pm and 5.30pm and until 7pm on Monday evening and until 7.15 on Tuesday evening.Leela Ltd is situated within the geographical area of Heywood, Middleton and Rochdale Commissioning Group (CCG).

The practice has a Personal Medical Services (PMS) contract. The PMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Leela Ltd is responsible for providing care to 4454 patients with a branch surgery at Bowness Road, Middleton. Patients are able to attend either surgery.

The practice consists of one lead,male GP partner and two long term locums, one male and one female, one practice nurse and one health care assistant. The practice is supported by a senior administrator and an administration and reception team.

When the practice is closed patients were directed to the out of hour’s service provided by Bury and Rochdale Doctors On Call (BARDOC).

The practice were part of a group of local practices and hosted the 7 day access service where patients could access a GP and a practice nurse 7 days a week.

Updated 28 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Leela Ltd on 8 August 2016. Overall the practice is rated as good.

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

• Risks to patients were assessed and well managed with the exception of staff acting as chaperones who had not received a check with the Disclosure and Barring Service.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• 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.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

The practice should complete the task of obtaining DBS checks for those staff acting as chaperones.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 28 October 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c (blood glucose level) is 64mmol or less in the preceding 12 months (1/4/2014 to 31/3/2015) was 49% which was comparable to the CCG average of 72%. On the day of inspection the practice provided evidence to show that in the following 12 months (1/4/2015 to 31/3/2016), this had increased to 66%.
• Patients were referred to the local Diabetic Nursing team as appropriate.
• 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.
• Care plans were offered to patients with more than a 30% risk of hospital admission.
• The practice worked with the CCG prescribing team to audit medications in those patients with long term conditions.

Updated 28 October 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify children living in disadvantaged circumstances and who were at risk, however there was not a robust system in place to follow up those children and young people who did not attend hospital appointments.
• Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• 76% of women aged between 25 and 64 had their notes recorded that a cervical screening test had been performed in the preceding five years which was lower than the national average of 82%. During the inspection the practice provided up to date evidence that this had increased to 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• Children under the age of 16 were offered same day appointments when required.
• A confidential chlamydia screening service was offered by the practice.

Updated 28 October 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population. The care plans included the named carer and avoidable admission advice.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs. For those at risk a home visiting service was offered by the GP and practice nurse.
• All elderly patients had a named GP.
• The practice embraced the Gold Standards Framework for end of life care. This included supporting patients’ choice to receive end of life care at home and included the recording of DNAR (do not attempt resuscitation) documentation.
• The practice identified and supported carers and signposted them to the relevant support services available.
• Telephone consultations were offered for patients that required them.
• The practice offered vaccinations and health checks which were appropriate for the age group such as over 75 checks, dementia screening and shingles and pneumococcal vaccinations.

Updated 28 October 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of this population group had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• Telephone appointments were available for those patients that required them.
• Extended hours were available with a GP and practice nurse every Monday and Tuesday evening.
• 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.
• The practice offered appointments with Big Life practitioners for patients that required lifestyle advice such as weight management and smoking cessation.
• The practice offered electronic prescribing meaning a patient could nominate a pharmacy where the GP sends prescriptions to, making the whole process more efficient and convenient for the patient.

Updated 28 October 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 73% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is lower than the national average.
• 93% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their record in the preceding 12 months which is above the national average of 88%.
• 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 had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• Carers names were added to patients’ records where consent for this had been obtained.

Updated 28 October 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• There were systems in place to identify children living in disadvantaged circumstances
• The practice held a register of patients living in vulnerable circumstances including military veterans, homeless people and those with a learning disability.
• 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.
• The practice took part in an alcohol reduction service.
• The practice had a guide dog policy.