The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Paul Downie Also known as Orchard House Surgery

Overall: Good read more about inspection ratings

Bleak Road,, Lydd,, Romney Marsh, Kent, TN29 9AE (01797) 320307

Provided and run by:
Dr Paul Downie

All Inspections

26 February 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Paul Downie on 26 February 2015. During the inspection we gathered information from a variety of sources. For example we spoke with patients, interviewed staff of all levels and checked the right systems and processes were in place.

Overall the practice is rated as good. This is because we found the practice to be good for providing effective, caring, responsive and well-led services. We found we found the practice to require improvement for providing safe services. It was good for providing services for the patient population groups of; older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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

  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents. Information about safety was recorded, monitored, reviewed and addressed. However there were areas such as infection control and recording of significant incidents where improvements are needed.
  • Risks to patients were assessed and well managed.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and additional training planned.
  • 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.
  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with 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 and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should

  • Ensure that all staff understand that they should consider reporting incidents that have the potential to be significant events.
  • Review patient specific directions to help ensure that the time they are valid for was clear to staff.
  • Complete the actions identified in their own infection control audit and in particular review: the use carpets throughout the practice, the use of fabric covered chairs in clinical rooms and the storage of clinical waste.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

28 June 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of patients who used the service. We talked to people observing interaction between staff and patients. We reviewed records and systems and looked at the environment and how this impacted on the service delivery. We spoke with seven patients who used the service. We spoke with staff that included; the practice manager, the practice nurse, the healthcare assistant, a receptionist, a secretary/receptionist and the salaried GP. We subsequently spoke with the principle GP over the telephone.

This told us the appointment system had worked well for patients. Patient's care needs had been assessed; they had time to discuss their health care issues, and had been fully involved in making decisions about their care and treatment. Comments received included 'They are very caring all of them,' and 'There is not a thing that I would say is wrong here.'

Policies and procedures were in place to protect vulnerable adults and children. Staff in the practice had received training to ensure they had an understanding of what constituted abuse.

Patients told us the practice was always clean. They could remember that clinical staff had washed their hands before examining them or carrying out a procedure.

Procedures were in place to respond to complaints and review the quality of the service provided.