Background to this inspection
Updated
26 November 2020
Following a joining of practices, a new partnership known and registered as Riverport Medical Practice became the provider for Orchard Surgery St. Ives and two branch sites.
The addresses are:
• Orchard Surgery St. Ives (the registered location), Constable Road, St. Ives, Cambridgeshire. PE27 3ER.
• Parkhall site, 2C, Parkhall Road, Somersham, Cambridgeshire. PE28 3EU.
• Fenstanton site, 7E, High Street, Fenstanton, Cambridgeshire. PE28 9LQ. This site, with the agreement of the Clinical Commissioning Group (CCG) was closed temporarily.
The practice is a dispensing practice and dispenses medicines from the Orchard Surgery St.Ives and Parkhall sites to patients that live more than a mile from a pharmacy.
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening
procedures, maternity and midwifery services, family planning, surgical procedures and treatment of disease, disorder or injury. These are delivered from all three sites.
Orchard Surgery St.Ives is situated within the Cambridge and Peterborough CCG area and provides services to 13,500 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community. The practice had accepted 700 new patients as a local GP practice was closed and the patient list dispersed amongst other local practices.
There are two GP partners (one male and one female) and the practice employs five salaried GPs, one advance nurse practitioner, one physician associate, four practice nurses, two health care assistants. There are four dispensary staff and a team over 20 non clinical staff.
Updated
26 November 2020
We carried out an announced comprehensive inspection at Orchard Surgery – St. Ives on 20 November 2020. We rated this service as good, overall. This inspection was carried out to review in detail the actions taken by the practice to improve the quality of care and to confirm that the practice was now meeting legal requirements.
At our inspection in March 2019, the practice was rated as good overall with a rating of requires improvement for providing safe services and good for providing effective, caring, responsive and well-led services. As a result of the findings on the day of the inspection the practice was issued with a requirement notice for Regulation 17 (Good governance).
At the previous comprehensive inspection published February 2020, the practice was rated as requires improvement overall with a rating of inadequate in providing safe services. The practice was rated as requires improvement for effective, caring and well-led services. The practice was rated as good for providing responsive services. As a result of the concerns identified, the provider was issued with a warning notice for breaches of Regulation 12, safe care and treatment and a requirement notice for breaches of Regulation 18, staffing.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information the practice sent to us prior to the inspection
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering how we carried out this inspection. We therefore undertook some of the inspection processes remotely and spent less time on site. We conducted staff interviews and reviewed documents sent by the provider from 9 November 2020 to 19 November 2020 and carried out a site visit on 20 November 2020.
At this inspection we have rated the practice as good overall and good for providing safe, caring, responsive and well led services. We have rated the practice as good overall for providing effective services and all population groups as good except working age people (including those recently retired and students). We have rated this population group as requires improvement because the practice was under the England target of 80% for cervical screening.
On this inspection we found;
- The practice had made the improvements identified at our last inspection and had made further improvements which had all been embedded to ensure they were sustained.
- The practice had implemented and embedded a practice intranet which had enhanced the communication across the practice sites. For example, they had increased the shared learning from significant events and complaints, training oversight and governance. Staff told us this system had been a positive introduction.
- The practice had encountered additional challenges to those presented with the COVID-19 pandemic. During August 2020, a nearby local practice had closed, and the practice had 700 new patients allocated to them at one time.
- This significant list size increase had led to some patients reporting lower satisfaction with access to the practice. The practice was aware of this and had made improvements.
- The practice had been successful in recruiting and retaining new clinical and non clinical staff.
The areas where the provider should make improvements are:
- Review and improve the record keeping for annual medicine reviews for patients to ensure clear and comprehensive records are in place.
- Continue to identify patients who are carers to ensure they receive appropriate support.
- Continue to encourage patients to attend their cancer screening appointments to improve uptake of this national programme.
- Continue to review and monitor patient feedback in relation to access to the practice, in particular to getting through on the telephone.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care