During an assessment under our new approach
Date of Assessment: 8 September 2025. Lapal Medical Practice is a GP practice and delivers services to 8,150 patients under a contract held with NHS England. 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.
The National General Practice Profiles states that the patient ethnicity profile is made up of 81.5% White, 9.6% Asian, 3.2% Black, 3.3% Mixed and 2.4% other ethnic groups. 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 found some areas required further strengthening to ensure risks were mitigated to ensure people were protected and kept safe. Staff managed most medicines well; but further improvements were needed in the management of long-term conditions, some Medicines and Healthcare products Regulatory Agency (MHRA) alerts, and medicines that required regular monitoring or review. We also found safeguarding registers required a review to ensure they were up to date and contained all the relevant information.
Staff understood and managed most risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks were mitigated. However, some actions from fire and health safety risk assessments had not been actioned. There were enough staff with the right skills, qualifications and experience. Annual supervision and prescribing audits were carried out on a random sample of nurse prescribers. We were told that support conversations were in place for non-medical prescribers, however we were unable to gain assurances on how regular these were held. Managers made sure staff received training and regular appraisals to maintain high-quality care.
People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. However, we identified that aspects of care planning for people with long-term conditions required further development to ensure consistency and comprehensive support. 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. Staff involved those important to people took 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 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.
There was a vision for the practice which the services evidenced during the assessment. However, not all staff we spoke with were aware of this. 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.
At the time of our assessment, the practice was undergoing a period of organisational transition between two managers. transition between leadership roles had some impact on governance and oversight.
We found breaches of regulation in relation to safe care and treatment. We have asked the provider for an action plan in response to the concerns found at this assessment.