The Care Quality Commission
  • Doctor
  • GP practice

Cambrian Surgery

Overall: Good read more about inspection ratings

Thomas Savin Road, Oswestry, Shropshire, SY11 1GA (01691) 652929

Provided and run by:
Cambrian Surgery

All Inspections

During an assessment under our new approach

Date of Assessment: 29 May 2025 to 3 June 2025

Cambrian Surgery is a GP practice and delivers service to 13,411 patients under a contract held with NHS England. The National General Practice Profiles states that the patient ethnicity profile is made up of 96.91% White, 1.23% Asian, 0.7% Black,0.7% Mixed and 0.46%. Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 6th decile (6 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.

SAFE: The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained but not all identified risks had been mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. However, there were a small number of concerns that the Care Quality Commission (CQC) identified in relation to providing safe services. These included the oversight of emergency medicines and the monitoring of people prescribed steroids for the exacerbation of asthma and the management of hypothyroidism. The authorisation of written instructions for administering of medicines also required attention and some minor issues relating to safe recruitment practices were identified. Following our site visit, the provider sent us information confirming the action they had since taken to mitigate risks to ensure people were protected and kept safe.

EFFECTIVE: People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. On the whole, care was based on latest evidence and good practice. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. Relevant forms were not available on the records of all patients with ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions recorded.

CARING: People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and treatment. The service supported staff wellbeing.

RESPONSIVE: People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took their feedback seriously and acted on it. Some patients found that the service was not always easy to access. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

The practice scored positively in the National GP Patient Survey regarding access to care and treatment. A total of 64% of respondents found it easy to contact the GP practice using their website, which was higher than the national average of 51%. A higher than national average of patients reported that they found it easy to contact the practice using the NHS App. Telephone access scored just below the national average at 51% of respondents found it was easy to get through to the practice by phone in comparison to national average of 53%. However, only 28% of patients reported they usually get to see or speak to their preferred healthcare professional when they would like to, which was below the national average of 40%

WELL-LED: Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas.

3 October 2016

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cambrian Surgery on 11 May 2016. After the comprehensive inspection, the practice was rated as good overall with requires improvement in providing safe services. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Cambrian Surgery on our website at www.cqc.org.uk. We undertook a focussed follow up inspection on 3 October 2016 to check that improvements had been made. The practice is rated as good for providing safe services and rated good overall.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting, recording and the learning from significant events.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • Risks to patients were assessed and well-managed and full clinical audits completed.
  • For patients on high-risk medicines and those requiring regular medicine reviews, these had been undertaken and systems were in place for medicine review monitoring.
  • Formal system for recording and monitoring medicines that on an ad hoc basis maybe taken by GPs to home visits was in place.
  • An audit about the identification of carers had been conducted and the numbers of carers on the practice register had increased.
  • General health and safety risk assessments had been completed, this included fire risk assessments, maintenance records and Legionella.
  • The practice ensured their recruitment arrangements included Disclosure and Barring Service (DBS) checks were completed for staff who had contact with potentially vulnerable patients including locum GP staff and references were recorded.
  • Staff who provide a chaperone service were in receipt of chaperone training and had a Disclosure and Barring Service (DBS) check completed.
  • Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. Training included a documented induction system and safeguarding adults and children to the appropriate levels as well as basic life support.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

11 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Cambrian Surgery on 11 May 2016. Overall the practice is rated as good.

Our key findings were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • 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. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and 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.
  • The provider was aware of and complied with the requirements of the duty of candour.

However, there were also areas of practice where the provider should make improvements:

  • Continue to increase the identification of patients who may be carers.

  • Improve the documentation of the learning, action points and trend analysis for significant incidents and events.

  • Ensure copies of the risk assessments such as fire checks and legionella records that were incomplete or missing from those reviewed are held by the practice.

  • Maintain a full recruitment record at the practice for the locum GPs used.

  • Improve the robustness of the medication review systems as we found that 18.3% of patients on specific medicines used to control blood pressure had not had a monitoring blood test in the last 12 months.

  • Create a formal system for recording and monitoring medicines that on an ad hoc basis maybe taken by GPs to home visits.

  • Complete full clinical audits where any improvements made can be implemented and monitored.

  • Review the practice policies and procedures to ensure they are in line with current best practice, have a review date and are readily available and easily located by staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

30 July 2013

During a routine inspection

We spoke with six patients during our visit. All of the patients we spoke with were generally pleased with the service they received from the practice. One patient said, 'Everyone is friendly and polite'. Patients told us that the doctors were approachable and happy to answer their questions.

We saw that the practice had policies and procedures in place to help protect patients' privacy and dignity. The staff we spoke with were familiar with the procedures. None of the patients we spoke with had any concerns in this area.

We found that care and treatment was planned and delivered in a way that met patients' needs and protected their rights. Patients were able to be involved in decisions about their treatment.

We found that patients received their treatment in a clean, hygienic environment. The practice had suitable arrangements in place to ensure patients were not placed at risk of cross infection.

We were satisfied that the provider made all the appropriate checks on staff before their full employment started. The practice manager regularly checked to ensure that healthcare professionals employed at the practice were correctly registered with their appropriate professional body.

We saw that the practice carried out a range of audits on a regular basis to monitor the quality of its own performance and to learn from any mistakes made. The practice had an active and effective patient participation group.