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The Orchard Medical Centre Good

Reports


Review carried out on 17 December 2019

During an annual regulatory review

We reviewed the information available to us about The Orchard Medical Centre on 17 December 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 1 February 2017

During an inspection to make sure that the improvements required had been made

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Orchard Medical Centre on 10 May 2016. The overall rating for the practice was good with the safe domain rated as requiring improvement. The practice needed to improve their systems in infection control, emergency medicines, vaccines and blank prescription management. The provider sent us an action plan following our inspection detailing how they would improve. The full comprehensive report from the May 2016 inspection can be found by selecting the ‘all reports’ link for The Orchard Medical Centre on our website at www.cqc.org.uk.

We undertook an announced focused inspection on the 1 February 2017 to confirm that the practice had carried out their action plan to meet the legal requirements in relation to the breach of regulation 17, good governance in which areas of concern had been identified during our previous inspection on the 10 May 2016. This report covers our findings in relation to those requirements and the improvements the provider had made since our last inspection.

Overall the practice is now rated as good for all domains.

Our key findings were as follows:

  • The practice now had good governance systems in place to assess, monitor and improve the quality of the service to ensure risks to patients' health and safety were minimised. For example, the auditing and monitoring of; infection control, emergency medicines and equipment, security of prescriptions and vaccines had now been improved.

The practice had two areas where they should improve following the inspection carried out in May 2016. We also reviewed these areas at this inspection.

In May 2016 we reported the practice should ensure that all required clinical staff were trained in accordance with best practice guidance for the insertion of intrauterine devices. We found on this inspection that the GP partners had reviewed who was appropriately trained to carry on providing this service to patients following the new best practice guidance from the Faculty of Sexual and Reproductive Healthcare. There were now two GPs who had the appropriate training and were identified as appropriate to carry out these procedures.

In May 2016 we reported the practice should improve on ensuring their systems for monitoring risks to patients, such as infection control and medical emergencies, were fully embedded within the staff team and were completed consistently. We found procedures were now embedded and carried out consistently within the staff team.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 10 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We had previously inspected this GP practice in August 2014 as part of our new inspection programme pilot to test our approach going forward.

The outcome from inspection Aug 2014 was that the provider should:

  • Identify a lead for infection prevention and control.

  • Review their appointment process to improve patient’s access to appointments with GPs.

  • Review their systems to ensure timely referral to other services.

  • Introduce a patient participation group (PPG) to seek feedback from patients about the way the practice runs.

We carried out an announced comprehensive inspection at The Orchard Medical Centre 10 May 2016. Overall the practice is rated as good, however, we found some areas of concern within the safe domain which is rated as requires improvement.

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

  • Risks to patients were assessed and well managed.
  • 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.
  • The practice was proactive in assessing patient access to the service and sourcing innovative solutions such as the employment of a practice pharmacist.
  • Some patients said they were able to make an appointment with a named GP; there were 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 with robust underpinning systems which supported the day to day activity of the practice.
  • Staff felt supported by management and there was a positive learning culture for staff development.
  • The practice proactively sought feedback from staff and patients through the patient participation group and patient surveys, 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:

  • The practice must ensure procedures are fully embedded bychecking their implementation, specifically in relation to the system for ensuring the safe storage of medicines which required refrigeration, prescription management,the process of audit of infection control measures and emergency equipment checking records.

The areas where the provider should make improvement are:

  • All practice staff should follow best practice guidance for updating training for the insertion of intrauterine devices.

  • The practice should ensure that clinical results are reviewed in a timely way following receipt by the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 7 August 2014

During a routine inspection

The Orchard Medical Centre is located in Kingswood within South Gloucestershire. The South Gloucestershire population is comparable to the England average with a high proportion of the population being between 40 and 49 years old. The Orchard Medical Centre provides a service to approximately 13700 patients.

The practice team consists of one managing partner andfive GP partners along with three practice nurses, three specialist nurses, three healthcare assistants and a reception and administration team.

We spoke with the South Gloucestershire Clinical Commissioning Group (CCG) and to Healthwatch South Gloucestershire about the practice before our visit. We visited The Orchard Medical Centre, Macdonald Walk, Kingswood, Bristol, BS15 8NJ.

We spoke to patients and some patients left written feedback in advance of the inspection. They gave us positive feedback about the practice and staff but they told us appointments with GPs were difficult to make. They told us they were pressurised to see the specialist nurse but preferred to see a GP.

We found that the practice was well-led and provided caring, effective, and responsive services to a wide range of patient population groups.

Patients had a named GP to oversee their individual care and treatment requirements delivered in the practice.

Patients with long-term conditions were helped by GPs and nurses to manage their conditions.

Pregnant women were able to have their antenatal care at the practice as well as their postnatal care following delivery.

The practice operated extended opening hours for patients of working age.

The practice worked with a local drug project to help patients with regimes to become drug free.

Patients with mental health care needs were registered at the practice.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.