Cricklade Surgery

Date of Assessment: 28 April to 6 May 2026. Cricklade Surgery is a GP practice and delivers services to approximately 3,400 people under a contract held with NHS England. The service also has a branch site at Ashton Keynes Village Hall. The National General Practice Profiles states the service has a higher-than-average number of people aged over 50. Information published by the Office for Health Improvement and Disparities shows deprivation in the service’s population group is in the 9th decile (9 out of 10). The lower the decile, the more deprived the 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.

We undertook this assessment to review the service’s compliance against the 3 Warning Notices issued following our last assessment in December 2025. The assessment focused on quality statements in the Safe, Effective and Well-led key questions which were related to the concerns detailed in the Warning Notices.

Arrangements for health and safety including fire safety did not keep people safe. Actions identified through risk assessments had still not been completed, and the service was unable to evidence compliance dates identified on risk assessments had been met. The service was still unable to evidence that incidents, complaints and significant events were thoroughly investigated and that learning was identified as a result. The service had failed to identify risks associated with medical emergencies, including appropriate access to emergency medicines, to ensure staff could respond to a medical emergency without delay. The service had still not ensured people received appropriate monitoring and interventions for prescribed medicines, and there continued to be delays in reviewing test results which placed people at risk of harm. The service had not ensured that all staff had received appropriate training and supervision for their role.

The service still did not follow national guidance in relation to monitoring of people with long-term conditions. The service had also not ensured all staff had received appropriate training and supervision for their role.

Systems and processes to assess, monitor and improve the quality and safety of the service remained ineffective. Leaders had not ensured sufficient oversight of risks, including health and safety, infection prevention and control, emergency medicines, staff immunisation records, and clinical waste management. Systems for investigating incidents, complaints and significant events were not operating effectively, and opportunities for learning were not consistently identified, shared or embedded. Actions identified through audits, risk assessments and improvement plans had not always been completed in a timely manner, including some actions identified after the compliance date specified in the Warning Notices.

The service was previously in breach of the legal regulation in relation to safe care and treatment, staffing and good governance. Improvements were not found at this assessment, and the service remained in breach of these regulations.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.

This service remains in special measures. The purpose of special measures is to ensure services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.

Date of Assessment: 5 December to 9 December 2025.

Cricklade Surgery is a GP practice and delivers service to 3,400 people under a contract held with NHS England. The service also has a branch site at Ashton Keynes Village Hall.

The National General Practice Profiles states the service has a higher-than-average number of people aged over 50. Information published by the Office for Health Improvement and Disparities shows deprivation in the service’s population group is in the 9th decile (9 out of 10). The lower the decile, the more deprived the 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 assessment focused on the safe, effective and well-led key questions. We undertook this assessment in response to information we held about the service.

The premises were clean and well maintained. However, the service did not always have effective processes or policies in place to mitigate potential risks relating to health and safety and fire safety. This included not having appropriately trained fire marshals or a designated health and safety lead.

The service had a designated infection prevention and control (IPC) lead, but some elements of responsibilities and policies were not in place. However, the IPC lead was newly appointed and was working on bringing the service in line with recommended guidance.

Staff recruitment files did not meet the full requirements of Schedule 3 of the Health and Social Care Act 2008. There was also insufficient oversight of recruitment checks, supervision processes, mandatory training compliance and prescribing audits.

Whilst people were involved in assessments of their needs, and staff supported them to understand their care and treatment, the service was not following national guidance in relation to monitoring long-term conditions. While no evidence of harm was found, the service’s recall systems were not fully effective. There were also delays in reviewing test results and clinical documentation, placing people at risk of harm.

However, staff made sure people understood their care and treatment so they could give informed consent. Staff involved those important to people and made decisions in people’s best interests when they did not have capacity.

There was not an effective system to assess, monitor and improve the quality and safety of the service. This included insufficient assurance that incidents, complaints and significant events were investigated thoroughly. As a result, learning and required actions were not always completed.

Leaders and staff did not always share a clear vision or culture based on listening, learning and trust. Staff told us leaders were not always visible, knowledgeable or supportive, and some reported they did not feel confident to provide feedback. While some staff were able to demonstrate an understanding of their roles and responsibilities, this was not consistent across the workforce.
We identified 4 breaches of the legal regulations relating to safe care and treatment; good governance, staffing, and fit and proper persons employed. In instances where CQC has decided to take civil enforcement action against the provider, we will publish this information on our website after any representations and/ or appeals have been concluded. We have also asked the provider for an action plan in response to the concerns found at this assessment.

This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.