Cam & Uley Family Practice Also known as The Orchard Medical Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People were involved in assessments of their needs. At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those individuals important to the person when making decisions in people’s best interests where they did not have capacity.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People felt involved in the assessment of their needs and felt confident that staff understood their individual and cultural needs. Staff were aware of the needs of the local community. Digital flags on people’s records highlighted the need for additional support, such as the requirement for longer appointments or for a translator to be present. Staff identified opportunities to refer people to social prescribers (a service that connects people to activities, groups, and services in their community) to help improve health and wellbeing. For example, to support with counselling and drug and alcohol services. Our clinical searches identified 1667 people on the asthma register, 121 of those people had been prescribed 2 or more rescue steroids (treatment for severe asthma episodes) in the last 12 months. We reviewed 5 patient records and found 4 people had not been reviewed appropriately in line with national guidance, including an assessment at the time of prescribing and a timely follow up to check the response to treatment. Following our on-site visit, the practice acted swiftly and implemented a new process to ensure people received the appropriate assessment and follow up. We reviewed the appointment diary and saw appointments were available to book the same day for urgent appointments and in the following few days for routine appointments.

Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we reviewed demonstrated care was provided in line with current guidance. Our clinical searches identified 427 people diagnosed with hypothyroidism (a condition where the thyroid does not produce enough hormones). We identified 6 people that had not received the appropriate monitoring in the last 18 months and reviewed their patient records. We reviewed 6 patient records and found 3 were overdue monitoring. The practice took action to contact these 3 people and identified this as an area to be highlighted in the medicines safety resource pack to accompany clinical medication review guidelines.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The practice worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services. People received consistent person-centred care when they moved between services. On the day of our site visit, there were 321 incoming clinic documents that required processing. The oldest document being actioned was from the 05 July 2025. The practice had an action plan in place to address this backlog.

The practice supported people to manage their health and wellbeing to maximise their independence, choice and control. The practice supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff focussed on identifying risks to people’s health, including for those in the last 12 months of their lives, people at risk of developing a long-term condition and those with caring responsibilities. Staff supported national priorities and initiatives to improve population health. The practice website contained information and links to other sources of information to support people to make healthier choices and support their lifestyles. People were able to self-refer to weight management and physiotherapy services.

There was a system in place to review health conditions such as diabetes and chronic kidney disease (CKD). However, our remote clinical searches identified some people had not been monitored appropriately. Following this being identified, the practice told us they had reviewed the people who required further monitoring and invited them in for review. For example, our clinical searches identified 35 people with chronic kidney disease stage 4-5. We looked at a sample of 4 patient records, and 3 had not had their U+E (Urea and Electrolytes – blood tests) monitored in the last 9 months. The practice took immediate action for these 3 people and had a plan to review the remaining 32 people. At the time of this inspection, the most recent verified data for cervical screening, dated June 2024, indicated that the practice was not meeting the national target uptake rate of 80%. Uptake was 77.2% among individuals aged 25–49 and 76.8% among those aged 50–64. However, the practice provided unverified data from July 2025, showing an improved uptake rate of 81.6% for the 25–49 age group and 82.1% for the 50–64 age group—exceeding the national target for both cohorts.

Staff understood and applied legislation relating to consent. Capacity and consent were clearly recorded. Staff had completed Mental Capacity Act Training. Policies, protocols and guidance followed supported people to make decisions and consent to care and treatment. Resuscitation Council Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) decisions were appropriate and were made in line with relevant legislation.