13 High Street

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that patients were protected from abuse and avoidable harm.

This is the first inspection for this service since its registration with the Care Quality Commission (CQC). This key question has been rated as good.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They told us they would listen to concerns about safety and would investigate and report safety events. Any lessons learnt would be used to continually identify and embed good practice.

There was an open culture, and safety was a top priority. The significant event policy set out the process to be followed when concerns were raised. The provider was aware of the duty of candour when dealing with significant events or complaints. There had not been any significant events or any complaints received during the previous 12 months.

The service worked with patients and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when patients moved between different services.

There were systems in place for processing information relating to new patients. The service’s referral and admission processes ensured that all essential information about the patient was received to determine if the patient’s needs could safely be met. Patients referred themselves to the service. Patients could book online, call or send an email. The provider had an online system for storing documents and information about patients.

The provider told us that most patients did not need any follow-up with the service. There may be occasions when this was necessary, such as if the wax was very hard and patients were offered appointments within a few days of their initial visit.

Staff would signpost patients to other services such as the local pharmacy and the patient’s own GP when needed. Staff were clear about the scope of their role and would ensure patients understood this when referring them to other services.

The service worked with patients and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving patients’ lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

The provider had a safeguarding policy, which identified potential safeguarding concerns and how these should be responded to. The policy included the contact details of statutory organisations, in the event that the provider needed to make a safeguarding referral or ask for advice if there were any safeguarding concerns.

The provider was a sole trader. They had completed level 3 safeguarding training for adults and Level 2 safeguarding training for children. They were advised to complete Level 3 safeguarding training for children as the ear wax removal service was available to both adults and children. They provided evidence they had competed this training following our assessment.

The provider had made no safeguarding referrals.

The service worked with patients to understand and manage risks by thinking holistically. They provided care to meet patients’ needs that was safe, supportive and enabled patients to do the things that mattered to them.

The service was co-located with a dental practice. Emergency equipment and medicines were available and were checked by the dental practice staff. However, the provider had not assured themselves these checks were taking place. Evidence to support this was provided following our assessment.

The provider was a registered nurse who also worked within the NHS. They could recognise a deteriorating patient and knew of action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

The service had suitable facilities to meet the needs of patients. The service was on the first floor of a shared building with other clinical healthcare professionals of differing disciplines and therapists. The waiting area was on the ground floor and patients had access to toilet facilities. The first floor was accessed via stairs, although the provider told us patients with mobility issues could be seen in a ground floor treatment room. The landlord was responsible for maintenance and health and safety within the wider building and communal areas.

The provider was responsible for the maintenance and health and safety within their room/area. The service was clean and generally well maintained. The provider followed policies to ensure the safety of the service. This included fire, health and safety, maintenance and infection prevention and control. The provider carried out regular risk assessments of their care environment.

The service had enough suitable equipment to help them to safely care for patients. Single use items were used where appropriate. Staff carried out daily safety checks of specialist equipment. All equipment was cleaned, soaked and sterilised as appropriate between each patient, with a thorough clean of the equipment and room at the end of each session. A deep clean was carried out once a month and records supported the cleaning programme. The machine that removed wax was checked before each use and replaced as required. Replacement equipment was available. Portable appliance testing (PAT) of electrical items in the service had been completed. The service had a first aid kit and body fluid spill kit. Staff disposed of clinical waste safely.

The landlord of the premises was responsible for building maintenance, emergency lighting and fire safety. The provider had not assured themselves that the premises and equipment were safe to use as they did not have access to all relevant records. Evidence to support this was provided following our assessment.

A fire risk assessment had been carried out in December 2024, and it was not clear if the recommendations in the risk assessment had been actioned. The periodic electrical wiring installation check had been completed in December 2024 and was satisfactory. There was no evidence to support maintenance of the fire alarm system and emergency lighting, or weekly fire alarm tests. Fire extinguishers were in place and serviced annually.

There was a business continuity plan which was monitored and reviewed.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met patients’ individual needs.

The provider was a sole trader, and the only person working in the service.

The provider had completed the necessary training to carry out ear wax removal through UK Microsuction Limited and to support weight loss management programmes through The National Weight Loss Programme.

The provider was up to date with appropriate mandatory training and ensured that this was repeated when necessary. This included fire safety, health and safety, resuscitation and basic life support, and moving and handling training.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was clean and well maintained. The provider had clear policies on how to clean both equipment used for treatment, and for the general areas of the service such as patient chairs and flooring. Cleaning records were up-to-date and demonstrated that all areas were cleaned regularly. Staff cleaned equipment after patient contact. Staff had completed infection prevention and control training.

Staff followed infection control principles including the use of personal protective equipment (PPE). PPE such as gloves and aprons were readily available.

The provider stored cleaning materials appropriately. There was a COSHH (Control of Substances Hazardous to Health) policy and risk assessments were in place, although the product data sheets were not available. This was addressed during our assessment.

The landlord was responsible for the routine legionella risk assessment / prevention strategy. The provider had not assured themselves that the landlord followed the routine legionella prevention strategies as they did not have access to all relevant records. Evidence to support this was provided following our assessment.

The legionella risk assessment had been completed in December 2024, and it was not clear if the recommendations in the risk assessment had been actioned. The landlord told us the risk assessment was rebooked for April 2026. Evidence of water temperature checks and flushing of water outlets was not available at the time of the assessment.

The provider ran the water outlets in the service prior to using water from either tap.

The service made sure that medicines and treatments were safe and met patients’ needs, capacities and preferences. They involved patients in planning, including when changes happened.

The provider was a sole trader who was a registered nurse. No medicines related to the removal of ear wax were kept on site. Clear advice was given to patients about suitable products to purchase and the provider worked closely with the local pharmacy to support patients to purchase appropriate products.

If the provider identified a medical problem that needed further attention, they advised the patient to seek medical treatment, such as from their GP. They wrote to the patient’s GP with their findings and requesting appropriate follow up.

Weight loss programme medicines were prescribed by the healthcare professional aligned to the service. However, the provider had not sought assurance that this was within the scope of competence for the health care professional. Evidence to support this was provided following our assessment.