During an assessment under our new approach
Date of Assessment: 16 – 17 February 2026
The Nile Practice is a GP practice, located in Cheslyn Hay, Walsall, and delivers services to 9,855 people under a contract held with NHS England. There are 2 branch practices, one in Cannock and another in Hednesford. We visited all 3 of these practices as part of our assessment. The service had recently appointed a new practice manager who was in the process of reviewing governance throughout the practice. We carried out this assessment because the practice has not been inspected since September 2017.
The National General Practice Profiles states that the ethnic make-up of the practice area is 96.5% white, 1.4% mixed, 1.4% Asian, 0.5% black and other 0.3%. Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 7th decile (7 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 had a good learning culture and people could raise concerns. Managers investigated incidents although supporting documentation lacked detail. There were systems in place to protect and keep people safe however, systems to corroborate safeguarding lists with the wider multi-disciplinary team were not in place and safeguarding alerts were not always added to appropriate patient records. The facilities and equipment met the needs of people, were clean and well-maintained. However, action plans to mitigate potential risks identified in the infection control audits were not always in place or appropriate. There were enough staff with the right skills, qualifications and experience. However, some staff had not received the required training, and regular appraisals had not been completed. Risk assessments to maintain a safe environment were not always completed or acted on. Safe recruitment practices were not always followed. Medicines and the tracking of prescription stationery were not always effective.
People were mostly involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Staff worked with some 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. Staff involved those important to people to make decisions in people’s best interests where they did not have capacity.
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 National GP Survey results supported this. The service supported staff wellbeing.
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 it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.
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 care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas. However, overarching governance arrangements lacked a formal structure and needed to be developed further and embedded into practice.
We found 3 breaches of regulations. One in relation to safe care and treatment. In particular, safeguarding arrangements, infection prevention and control, safe environments and medicines optimisation. Another in relation to safe recruitment and effective staffing. A 3rd relates to effective systems and processes to ensure good governance. We have asked the provider for an action plan in response to the concerns found at this assessment.