During an assessment under our new approach
Date of Assessment: 21 to 23 April 2026. On 21 April 2026 we carried out remote clinical searches of the patient’s records, and on 23 April 2026, we carried out a visit to the practice.
Lanchester Medical Centre is a GP practice and delivers service to approximately 4,100 patients under a contract held with NHS England. The provider of this service is Dr Harpreet Singh Kalra. They are also registered to provide services at another separately registered GP practice, which was not inspected as part of this assessment.
We carried out this inspection to follow up on previous breaches of regulation. We inspected the service in July 2025 and imposed conditions on the provider’s registration at this location. This inspection was to check if improvements had been made. Dr Kalra did not provide any regulated activities from Lanchester Medical Centre between 12 August 2025 until 14 November 2025 as a result of conditions we imposed on his registration. The provider agreed to extend this until January 2026. During this time, another provider was commissioned to provide the service on Dr Kalra’s behalf. At the time of our inspection on 21 and 23 April 2026, Dr Kalra had only resumed sole control for a few weeks.
Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 8th decile (8 of 10). The lower the decile, the more deprived the practice population is relative to others. This assessment considered the demographics of the people using the service, the context the service was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.
The service did not always listen to concerns about safety or fully investigate and learn from safety events and incidents. People were mostly protected and kept safe; however, the practice had not been able to mitigate risks arising from ineffective partnership working. We found some improvements had been made to the way the service worked with people to understand and manage risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. Although we found there were enough staff with the right skills, qualifications and experience, the sustainability of these arrangements will take time to embed. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes. Although the provider had processes in place to act upon patient safety alerts, we were not assured there was a system in place to re-audit on an ongoing basis to demonstrate ongoing compliance.
The service had made improvements since the last CQC inspection, and now ensured people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People were involved in assessments of their needs. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving between services. However, some working relationships within the practice were still strained and the culture within the practice did not always support positive and productive working relationships. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those important to people and took decisions in people’s best interests where they did not have capacity.
People were mostly treated with kindness and compassion. However, the ineffective complaints process had led to patient distrust and a feeling that their views were not valued. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. The service did not always listen to and understand people’s needs, views and wishes. The service did not adequately promote or support the wellbeing of their staff. The culture in the workplace remained stressful, staff morale was low and there was a lack of psychological safety.
People were involved in decisions about their care. Although staff provided inclusive care and treated people equally, learning from complaints and events was not embedded, and feedback indicated mixed patient experiences, meaning further work was needed to deliver consistently responsive, high-quality care. Complaints responses lacked evidence, clarity and learning and were not always provided in a timely manner.
The practice had a vision and strategy, with a clear focus on improvement. However, this was not always shared and the culture within the service acted as a potential barrier to improvement and the embedding of any new processes and procedures. There was a perception from some of a lack of leadership within the practice and that the provider did not ‘own’ the previously identified failings. Some staff told us they did not feel valued, and there was little evidence some had been involved in change processes. The service had strengthened aspects of its governance, and the provider demonstrated more effective oversight of quality and safety. However, there were still some gaps in governance arrangements, and the provider did not always use information about safety and quality effectively.
We found continued breaches of regulation in relation to receiving and acting upon complaints and good governance. The provider had made some improvements within these areas but had not yet achieved compliance. We have asked the provider for an action plan in response to the concerns found at this assessment.
Since the last inspection, the practice had made improvements and is no longer in breach of safe care and treatment.
This service was placed in Special Measures on 30 October 2025. The provider demonstrated improvements that have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.