Background to this inspection
Updated
31 May 2019
Healthy Balance provides private GP services including a joint injection clinic to adults and children. The registered provider is Healthy Balance Clinics Limited. Services are provided from:
- Healthy Balance, 51 High Street, Great Missenden, Buckinghamshire HP16 0AL
The service website is:
- www.healthy-balance.co.uk
Healthy Balance was founded in 2002 and is located in converted premises within Great Missenden in Buckinghamshire. All Healthy Balance services including GP services are provided from the same premises, which contain a minor operations suite, a talking therapy room and three treatment rooms. There is an open plan reception area and waiting area with a variety of seating. Some of the services available at Healthy Balance are exempt by law from Care Quality Commission (CQC) regulation. Therefore, we were only able to inspect the provision of GP services and joint injection clinic as part of this inspection.
The GP services team provided at Healthy Balance consist of one male GP (there were arrangements to access a female locum GP if required), a practice manager, reception manager and receptionist.
Healthy Balance also provide GP services to patients from foreign countries who require medical assistance whilst visiting the UK from abroad. These are mostly single consultations.
Healthy Balance has core opening hours of Monday to Friday from 9am to 5pm. In addition to the core hours, Healthy Balance is open until 8pm on Tuesday and Wednesday evenings and between 9am and 12 noon each Saturday. This service is not required to offer an out of hours service. Patients who need medical assistance out of corporate operating hours are requested to seek assistance from alternative services. This is detailed in patient literature supplied by the service.
How we inspected this service
Our inspection was led by a Care Quality Commission (CQC) lead inspector, the team included a GP specialist adviser.
During our visit we:
- Spoke with a range of staff, including the GP who provided GP services and the practice manager who manages the full range of services including the GP services.
- Reviewed comment cards where patients and members of the public shared their views and experiences of the service.
- Looked at information the service used to deliver care and treatment plans.
- Reviewed documents relating to the service.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:
- Is it safe?
- Is it effective?
- Is it caring?
- Is it responsive to people’s needs?
- Is it well-led?
These questions therefore formed the framework for the areas we looked at during the inspection.
Updated
31 May 2019
This service is rated as Good overall.
The previous inspection was in February 2018.
The inspection report for the previous inspection can be found by selecting the ‘all services’ link for Healthy Balance on our website at www.cqc.org.uk.
Since the February 2018 inspection, our methodology has now changed and therefore this is a rated inspection and the key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Good
We carried out an announced comprehensive inspection at Healthy Balance in Buckinghamshire on 20 May 2019. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
Healthy Balance is registered with Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Some of the services available at Healthy Balance, for example chiropody, osteopathy and nutrition services, are exempt by law from CQC regulation. Therefore we were only able to inspect the GP service including the joint injection clinic as part of this inspection.
The Practice Manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
As part of our inspection we asked for CQC comment cards to be completed by patients prior to our inspection, we received 30 completed comment cards which were all positive about the standard of care they received. The service was described as first-rate and professional, whilst staff were described as attentive, helpful and caring. Many cards referred to the GP service, however there was no method to establish exactly how many of the 30 cards referred to the GP services provided.
Our key findings were:
- The GP service within Healthy Balance was providing safe, effective, caring, responsive and well led care in accordance with the relevant regulations.
- There were systems in place for the overall management of significant events and incidents. Risks to patients were assessed and managed.
- Staff treated patients with compassion, kindness, dignity and respect.
- There was a process to ensure that care and treatment delivered were in accordance with evidence-based guidelines.
- Staff demonstrated that they understood their responsibilities, and all had received training on safeguarding children and vulnerable adults relevant to their role.
- Patient feedback highlighted that patients appreciated the care provided and described the service as first class, caring and patient focused.
- There were systems to support improvement and innovation work. For example, in partnership with Bucks County Council, the service was awarded a 'Safe Place' status. This scheme provides reassurance to vulnerable people, and to their families and carers, so that they have a means to alert someone of any potential risk or emergency if they are out alone.
We saw an area of outstanding practice:
- Given the low numbers of significant events, the service had contacted a local GP practice and the clinical commissioning group and requested three anonymised significant events. We saw the service used these external significant events as a learning opportunity and reviewed the incident alongside their own significant event processes and procedures to ensure they were effective.
Whilst we found no breaches of regulations, the provider should:
- Review and implement a programme with the view to increase the level of quality improvement; this may include further clinical audit activity.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care