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We are carrying out a review of quality at Orient Practice. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary

Overall summary & rating


Updated 2 April 2019

We carried out an announced comprehensive inspection at The Orient Practice on 5 and 7 February 2019.

At this inspection we followed up on breaches of regulations identified at a previous inspection on 2 July 2018.

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 rated this practice inadequate overall.

We rated the practice as inadequate for providing safe services because:

  • The practice did not have clear systems to keep patients safe.
  • Risks were not adequately assessed and monitored.
  • The practice did not have appropriate systems in place for the safe management of medicines.
  • The practice did not have appropriate recruitment processes.
  • There was insufficient learning when things went wrong.

We rated the practice as inadequate for providing effective services because:

  • The practice was unable to show that staff had the skills, knowledge and experience to carry out their roles.
  • The practice was unable to demonstrate that patients’ needs were fully assessed.
  • No action had been taken to improve the uptake of childhood immunisations.
  • Staff learning and development needs were not assessed.

We rated the practice as inadequate for providing well-led services because:

  • There had been minimal improvements made since our inspection on 2 July 2018, it had not appropriately addressed the Warning Notice in relation to learning from significant events, safeguarding systems, governance processes and management capacity. At this inspection, we also identified additional concerns that put patients at risk.
  • Leaders could not show that they had the capacity and skills to deliver high quality sustainable care.
  • While the practice had a vision, this was not supported by a strategy.
  • The practice culture did not effectively support high quality sustainable care.
  • The overall governance was ineffective.
  • The practice did not have clear and effective processes for managing risks, issues and performance.
  • The practice did not always act on appropriate and accurate information.
  • The practice did not promote an environment where learning and improvement was a priority.

These areas affected all population groups, so we rated all population groups as inadequate.

We rated the practice as requires improvement for providing responsive services because:

  • The practice did not mitigate risks of cancelling appointments when they had advanced notice.
  • There was insufficient learning from complaints and they were not handled appropriately or in a timely way.

We rated the practice as good for providing caring services because:

  • Staff dealt with patients with kindness and respect.
  • Patients rated the practice favourably in questions relating to the practice being caring in the national GP patient survey.

Following this inspection on 5 and 7 February 2019, urgent action was taken. The provider was served with a Section 30 conditions of registration and The Orient Practice was removed from Living Care as one of their registered locations. The practice was subsequently placed in the care of a care taking provider.

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

Inspection areas


Requires improvement
Checks on specific services

People with long term conditions


Families, children and young people


Older people


Working age people (including those recently retired and students)


People experiencing poor mental health (including people with dementia)


People whose circumstances may make them vulnerable