Orchard Surgery

Updated 25 May 2023

Orchard Surgery is located in Dereham at:

Commercial Road

East Dereham

Norfolk

NR19 1AE

The provider is registered with CQC to deliver the Regulated Activities; treatment of disease, disorder or injury, surgical procedures, diagnostic and screening procedures, maternity and midwifery services and family planning services.

The practice is situated within the Norfolk and Waveney Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a patient population of about 11,000. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices which make up the Mid Norfolk Primary Care Network (PCN) .

Information published by Public Health England shows that deprivation within the practice population group is in the sixth highest decile (6 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 98% White, 1% Asian and 1% Mixed. The age distribution of the practice population mirrors the local and national averages.

There is a team of 3 GP partners who provide cover at the practice. The practice has a team of 5 nurses who provide nurse led clinics. The GPs are supported at the practice by a team of reception/administration staff. The practice manager and operations manager are based at the practice location to provide managerial oversight.

The practice is open between 8am to 6pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided by the practice with early morning appointments available on Thursdays. Out of hours services are provided by Integrated Care 24 (IC24) and accessed by calling the NHS 111 service.

Updated 25 May 2023

We carried out an announced comprehensive inspection at Orchard Surgery on 4 May 2023. Overall, the practice is rated as good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 14 June 2022, the practice was rated inadequate overall and for providing safe, effective and well-led services, requires improvement for providing responsive services and good for providing caring services. The practice was placed into special measures and issued with conditions relating to a breach of regulations.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Orchard Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out an announced comprehensive inspection as the practice was in special measures and had had conditions imposed on their registration. This inspection was to review in detail the actions taken by the provider to improve the quality of care and to confirm whether legal requirements were now being met. The focus of this inspection included:

• The key questions of safe, effective, caring, responsive and well led.
• The follow up of areas where the provider ‘should’ improve identified in our previous inspection.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

Our findings

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 found that:

• Significant improvements had been made to the leadership in the practice and the leaders had worked well together and with the Integrated Care Board (ICB) to effect change and improvement in the practice.
• The practice now provided care in a way that kept patients safe and protected them from avoidable harm.
• 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.
• Patients could access care and treatment in a timely way.
• The way the practice was led and managed now promoted the delivery of high-quality, person-centre care.

The practice had fully engaged with the findings of our last report, had worked comprehensively together and with the ICB and an external team, and had identified a recovery plan, made significant changes, monitored and ensured those improvements had been sustained. Feedback from staff was positive about the changes and the future.

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

• Continue to monitor and improve the management of long term conditions for example diabetes and asthma.
• Continue to monitor and improve the identification of carers in the practice.
• Continue to encourage the uptake of cervical screening.

I am taking this service out of special measures and the conditions that were imposed on the practice will be removed.

This recognises the significant improvements which have been made to the quality of care provided by this service.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services