A GP surgery which didn’t have oxygen available in case of emergency has been placed in special measures.

Health inspectors could find no evidence that staff had been trained about infection prevention and control at Five Elms Medical Practice, which could be forced to close unless it substantially improves within the next six months.

The clinic – which has 4,300 patients on its books – was rated “inadequate” in all five areas of a Care Quality Commission (CQC) report published on Thursday.

Concerns raised include no record of staff at the Five Elms Road centre having carried out any fire drills at all.

The report was written following a visit by inspectors in April when they discovered that vulnerable adults were not always receiving the care that they required.

Only a quarter of dementia sufferers had a care plan in place, while patients experiencing poor mental health were not told about support groups that could help them.

Despite having a far higher proportion of over 65s than the national average (17pc rather than the average nine pc), provision for older people was also rated as inadequate. Although over-75s were given a telephone number which bypassed the main switchboard, just 17pc of survey respondents found it easy to get through.

“Patients were at risk of harm because systems and processes were not in place to keep them safe,” wrote Professor Steve Field, chief inspector of general practice, in his findings.

He also found that following “unintended or unexpected” safety incidents, reviews and investigations were not communicated widely enough to lead to improvements.

Prof Field added that there was “no evidence” that the practice was comparing its performance to others, locally or nationally.

Although only 44 per cent surveyed said the last GP they saw was good at treating them with care or concern – nearly half of the national average – patients did say that they were treated with “compassion and dignity”.

Leadership was flagged up as another issue at the surgery. There have been three practice managers in three years, with no replacement since the most recent departed in April last year.

The report states that there is “no clear leadership structure, insufficient leadership capacity and limited formal governance arrangements”.

Infection control, staff training and better patient feedback are among the areas outlined by improvement – otherwise “urgent enforcement action” could be taken.

“If there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration,” Prof Field concludes.

A spokeswoman for the practice declined to comment.