Bellingham Practice Also known as The Bellingham Practice

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 staff protected people from avoidable harm and made sure care was delivered from environments that were clean and well maintained. At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service had systems to identify and manage risks within the care environment; however, these were not always sufficiently effective. The practice had experienced flooding which affected the hot water supply in several clinical rooms. At the time of the assessment, affected rooms remained in use and staff described mitigation measures that had been implemented to reduce risks. However, we did not see a documented risk assessment setting out how risks associated with continued use of these rooms were being managed. There was also no signage to alert staff to the restrictions in these rooms. Following the assessment, the provider submitted a risk assessment detailing interim arrangements, including the allocation of higher-risk procedures to areas with fully functioning hot and cold-water supplies, staff communication processes and ongoing monitoring arrangements. The provider also submitted evidence of signage which they told us had subsequently been displayed in the affected rooms.

It was also not clear how the practice assured itself that the person completing their Legionella risk assessment had appropriate training and knowledge to undertake this role. Following the assessment, the practice confirmed future Legionella risk assessments would be undertaken by an external contractor.

The provider had arrangements for the ongoing maintenance of the premises. Staff and leaders completed health and safety risk assessments and undertook audits to identify and manage environmental risks. The service had a business continuity plan which was regularly reviewed and outlined how the service should continue to operate in the event of a disruption.

The service generally 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 people’s individual needs.

The service employed a range of clinical and non-clinical staff, which included GPs and nurses. The practice had access to additional roles through the Primary Care Network (PCN), including a pharmacist. Leaders ensured staff were up to date with their training which the service had deemed mandatory and operated within their agreed areas of competence. The service generally followed safe recruitment procedures when employing staff, which were in line with national legislation. This included identity checks, review of qualifications, obtaining of professional references and a criminal records check. During the assessment, evidence of identity checks was not available in 1 staff recruitment file reviewed. The provider supplied copies of the staff member's identification later that day, demonstrating the checks had been completed but records were not readily available at the time of the assessment.

We reviewed arrangements for staff support and supervision. The Non-Medical Prescriber (NMP) received 4-monthly supervision and case discussion sessions. While these sessions took place regularly, the content and outcomes were not routinely documented.

However, we identified that members of the cleaning team had not completed safeguarding training despite working within the practice premises during periods when patients were present. Leaders acknowledged this and told us arrangements would be made to ensure the required training was completed.

The service had systems to assess and manage the risk of infection; however, some infection prevention and control (IPC) measures were not always sufficiently effective.

Some clinical rooms did not have access to hot water following recent flood damage. During the assessment, there was no signage displayed in the affected rooms, and we received differing information about how hand hygiene was being managed. This did not provide assurance that clear and consistent arrangements were in place. Following the assessment, the provider submitted additional IPC guidance which included arrangements for the use of alcohol hand gel, access to alternative handwashing facilities and signage for the affected rooms.

The service had cleaning schedules available, which outlined how staff should clean the building and its equipment. The service demonstrated how these were monitored for completion to maintain oversight of cleaning arrangements. During our onsite visit, the service's premises and a sample of equipment reviewed was noted to be visibly clean. The service’s infection prevention and control lead conducted regular risk assessments and audits, and staff had completed relevant training in infection prevention and control.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.