The Orchard Surgery

Updated 30 May 2022

The Orchard Surgery is located at Horseshoes Lane, Langley, Maidstone, ME17 3JY. The practice offers dispensing services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy.

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

The practice is situated within the NHS Kent and Medway Clinical Commissioning Group (CCG) and delivers General Medical Services (GMS) to a patient population of about 3,400.

The practice is part of a wider network of GP practices: The Ridge Primary Care Network (PCN).

Information published by Public Health England shows that deprivation score within the practice population group is five (seven of ten). The lower the score, 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 96.9% White 1.2% Asian, 0.6% Black, 1.1% Mixed and 0.1% Other.

The number of patients under the age of 18, aged 18 to 64 and over the age of 65 closely mirrors the local and national averages.

The practice consists of one principal GP (female), two salaried GPs (male), one practice nurse (female), one advanced nurse practitioner (female) and two healthcare practitioners (female). The practice is supported by a team of dispensing, reception and administration staff. The practice also employs locum GPs via an agency when required.

Extended access is provided locally by the PCN, where late evening and weekend appointments are available. Out of hours services are provided by NHS 111 and Integrated Care 24 (IC24). NHS 111 and IC24 deals with urgent care problems when GP surgeries are closed.

Updated 30 May 2022

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced inspection at The Orchard Surgery. We conducted remote clinical searches on the practice’s computer system on 28 April 2022 and conducted an onsite inspection of the practice on 29 April 2022 under Section 60 of the Health and Social Care Act 2008, as part of our regulatory functions. The provider registered with the CQC on 17 July 2020. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• 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 have rated this practice as Good overall

We found that:

• 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.
• The provider adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• The practice respected patients’ privacy and dignity.
• There was compassionate and inclusive leadership at all levels.
• The provider learned and made improvements when things went wrong.
• Staff had the skills, knowledge and experience to carry out their roles.
• Appropriate standards of cleanliness and hygiene were met.
• Systems for managing safety alerts were effective.

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

• Continue to ensure compliance with the action plans and completion dates in relation to fire safety, infection prevention and control and any associated risk assessments.
• Continue to monitor patient’s health in relation to the use of medicines including high-risk medicines and to regularly review and update patients’ treatment in relation to monitoring long term conditions.
• Continue to recruit and communicate with members of the patient participation group.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care