Balance Street 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 people were protected from abuse and avoidable harm. At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 75 (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 mostly detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The service had contracts to ensure the premises were maintained. Staff and leaders completed health and safety risk assessments and undertook audits to ensure they had identified and addressed risks. For example, fire safety and legionella. The service had a business continuity plan which was regularly monitored and reviewed. It outlined how the service should continue to operate in the event of a disruption. However, systems for tracking prescription stationery throughout the practice were not in place. Following our assessment the provider sent us their updated protocol for tracking prescription stationery throughout the practice and evidence of how this was recorded.

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 people’s individual needs.

The service employed a range of clinical and non-clinical roles, which included GPs, nurses, nurse associates, care co-ordinators and pharmacists. Leaders ensured staff were up to date with their training which the service had deemed mandatory and operated within their agreed areas of competence. Staff told us they received regular appraisals and where they identified additional training to support them in their role, leaders supported them to access this. For example, the lead for infection control and prevention (IPC) and their supervisor had identified a 2-day IPC course which leaders provided time for them to attend. Non-medical prescribers received clinical supervision however, this was not always documented. Following our assessment the provider sent us evidence of the new recording system they had put in place and their new policy for the auditing of the prescribing of non-medical prescribers to inform the clinical supervision process.

We found that recently recruited staff had been recruited in line with national legislation. This included identity checks, review of qualifications, obtaining of professional references and a criminal records check. However, staff on zero hours contracts were not fully compliant with these checks and, there was not always a full immunisation history, or risk assessment, of staff vaccinations against potential healthcare acquired infections. Following our assessment the provider implemented a new staff immunisation policy and sent us an example of a risk assessment completed for a clinical member of staff.

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 had completed cleaning schedules for cleaning staff which outlined how staff should clean the building. The service demonstrated how these were monitored to maintain oversight of cleaning arrangements. The service was in the process of implementing a QR code system of cleaning schedules for clinical staff to clean their rooms and equipment.

During our onsite visit, the service's premises and a sample of equipment reviewed was visibly clean. The service’s infection prevention and control (IPC) lead conducted monthly IPC risk assessments and audits to ensure compliance and took action where necessary to mitigate any identified risks. An action plan was being developed to capture areas that need to be addressed. The IPC audit had not identified sinks with overflows as a potential IPC risk. Following our assessment, the provider sent us a risk assessment which detailed how this risk would be managed and updated their IPC action plan accordingly. A hand hygiene audit had been completed, and staff reported that the IPC lead was highly focused on ensuring effective hand washing practices. Staff had completed relevant training in IPC.

The CQC received 109 Give Feedback on Care comments from patients throughout this assessment. Of these, 101 were overwhelmingly positive compared to 8 mixed comments. The feedback showed that people felt there was a clean, safe, and welcoming environment. They described the premises as clean, well-maintained, pleasant and calm.

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