We carried out an announced comprehensive inspection at The Orchard Practice on 18 December 2018 as part of our inspection programme.

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.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm; however, there were some areas where processes required review to ensure they continued to adhere to best practice.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Update their safeguarding policies to include reference to the process for identifying and reporting people at risk of female genital mutilation.
• Review their infection control audit to ensure that all necessary actions have been completed.
• Provide information and training to reception staff on identifying patients with potential sepsis.
• Review the arrangements for the monitoring of blank prescription stationery.
• Review and risk assess the arrangements in place for prescribing Warfarin.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

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

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Orchard Practice on 12 May 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was outstanding for providing services for patients with long term conditions and good for all the population groups including older people;  mothers, babies, children and young people; the working age populations and those recently retired; people in vulnerable circumstances and people experiencing poor mental health.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 found it easy to make an appointment with a named GP and that 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.

We saw several areas of outstanding practice including:

• The practice had implemented a monthly audiology clinic for hearing aid users (registered and non-registered patients) to have their hearing aids serviced and repaired. This helped local patients avoid long bus trips to the hospital.

• The healthcare assistant responsible for smoking cessation had won a CCG award for their work in smoking cessation and for two years running the practice had the second highest quit rate in the CCG.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice