During an assessment under our new approach
Date of Assessment: 16 October 2025 to 21 October 2025. The Grange Practice is a GP practice and delivers services to approximately 12,560 patients under a contract held with NHS England. The National General Practice Profiles states that the ethnic make-up of the practice area is 93.6% White, 0.85% Black, 2.6% Asian, 2.4% Mixed and 0.9% Other. Information published by the office for health improvement and disparities shows that deprivation within the practice population group is in the 3rd decile (3 of 10). The lower the decile, the more deprived the practice population is relative to others. This assessment considered the demographics of the patients 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. At this assessment, we looked at the key questions safe, effective, caring, responsive and well-led.
The practice did not have established systems to ensure the monitoring of day to day fire safety risks were documented. We also found the practice had not formally assessed the risks to health and safety at the practice.Staff designated as fire wardens had not completed their required annual refresher training. We found some high-risk medicines were not monitored in accordance with national guidance. We also found some medicine reviews had been coded as completed but there were no entries clearly documented in the patient records to support this. There were not effective processes to ensure information was reviewed and actioned in a timely and appropriate manner, for example there was a backlog of patient paper records awaiting summarisation and there were electronic documents awaiting processing. However, the practice had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received regular appraisals to maintain high-quality care.
Patients were involved in assessments of their needs. Staff reviewed assessments taking account of patient’s communication, personal and health needs. Staff worked with all agencies involved in patient’s care for the best outcomes and smooth transitions when moving services. Improvements were identified regarding the monitoring of some long-term conditions.
Patients were generally treated with kindness, compassion, and respect for their privacy and dignity. Staff supported individual preferences and promoted choice in care and treatment. The practice also demonstrated a commitment to staff wellbeing.
Patients reported difficulties contacting the practice by telephone. According to the national GP patient survey (2025) 27% of respondents said it was easy to contact the practice by phone, which was below the national average of 52%.
However, patients were involved in decisions about their care. The practice provided information patients could understand. Patients were involved in planning their care and understood options around choosing to withdraw or not receive care.
Improvements were required in some governance systems. The practice did not always have effective systems to identify, mitigate, manage or remove risks to patient safety in relation to fire safety, legionella monitoring and health and safety concerns. Improvements were required for the monitoring of some high-risk medicines and long-term conditions. Governance systems were not effective to ensure timely and appropriate review and action of some patient information. For example, the summarisation of paper patient records and electronic documents.
Managers worked with the local community to deliver the best possible care and were receptive to new ideas. Leaders and staff had a shared vision based on listening, learning and trust.
We found breaches of legal regulation in relation to safe care and treatment and good governance. We have asked the practice for an action plan in response to the concerns found at this assessment.