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Balance Street Practice Good

We are carrying out a review of quality at Balance Street Practice. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary

Overall summary & rating


Updated 26 March 2019

We carried out an announced comprehensive inspection at Balance Street Practice on 19 February 2019. The announced inspection was part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

  • What we found when we inspected
  • Information from our ongoing monitoring of data about services and
  • Information from the provider, patients, the public and other organisations

We have rated this practice as Good overall.

We rated the practice as requires improvement for providing safe services because:

  • The systems, processes and practice that helped to keep patients safe and safeguarded from abuse were insufficient. Not all staff had been in receipt of safeguard training to the level appropriate for their role.
  • There were gaps in the process for monitoring patients’ health in relation to the use of high risk medicines.

We rated the practice as good for providing effective services because:

  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.

We rated the practice as good for providing a caring service because:

  • Patients reportedly positively on being treated with care and concern and had confidence and trust in the healthcare professional they saw or spoke to.
  • The practice National GP Survey results were above the local clinical commissioning group and England averages. However, improvement in the carer register numbers was required as only 97 registered patients were electronically coded as being a carer which represented 0.7% of the practice population.

We rated the practice as good for providing a responsive service because:

  • The practice organised and delivered services to meet patients’ needs.
  • The practice National GP survey findings were in line with or above the local clinical commissioning group and England averages in respect of patient access.

We rated the practice as good for providing a well led service because:

  • The practice had developed an action plan to meet the needs of its registered population whilst bearing in mind the aims and objectives of the wider health economy.
  • Identified gaps in the practice governance processes had been proactively managed to reduce risk and to develop sustainable care. However, some policies we reviewed required clinical oversight and were overdue a review.

These areas affected all population groups, so we rated all population groups as good, except for families, children and young people which was rated requires improvement in effective and therefore rated as requires improvement overall.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure that care and treatment is provided in a safe way.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Implement safeguard policy updates in line with local and national guidance changes.
  • Develop the staff training matrix which enables clear oversight on all staff training.
  • Continue to improve the practice carer register numbers.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas


Requires improvement








Checks on specific services

People with long term conditions


Families, children and young people

Requires improvement

Older people


Working age people (including those recently retired and students)


People experiencing poor mental health (including people with dementia)


People whose circumstances may make them vulnerable