The Care Quality Commission
  • Doctor
  • GP practice

Archived: Balham Hill Medical Practice

Overall: Inadequate read more about inspection ratings

143-145 Balham Hill, Balham, London, SW12 9DL (020) 8673 1776

Provided and run by:
Balham Hill Medical Practice

All Inspections

26 October 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Balham Hill Medical Centre on 26 October 2016. Overall the practice is rated as inadequate.

Our key findings across all the areas we inspected were as follows:

  • Patients were at risk of harm because systems and processes were not in place to keep them safe. For example, infection control audit findings had not been actioned and clinical equipment had not been calibrated. The practice was also not equipped to deal with medical emergencies.

  • Staff were not clear about reporting incidents, near misses and concerns and there was no evidence of learning and communication with staff.

  • Patient outcomes were in line with national averages in all areas with the exception of the management of diabetes. There were only limited audits and quality improvement at the practice.

  • Patients were positive about their interactions with non-clinical and nursing staff and said they were treated with compassion and dignity. However, they reported that GP’s did not treat them with dignity and respect.

  • Patients were able to access appointments at short notice.

  • The practice had no clear leadership structure, insufficient leadership capacity and limited formal governance arrangements.

The areas where the provider must make improvements are:

  • Implement formal governance arrangements including systems for assessing and monitoring risks (including significant event analysis, and a business continuity plan) and the quality of the service provision (including audit/quality review). The practice should ensure that staff are able to carry out their roles in a safe and effective manner which are reflective of the requirements of the practice, including ensuring that all staff are aware of their safeguarding responsibilities. All staff must also have appraisal as necessary to enable them to carry out their duties

  • Ensure that there is appropriate equipment in place to manage emergencies and that the all potential risks have been assessed in the practice.
  • Ensure that all clinical equipment is calibrated.
  • Ensure that systems are in place to effectively monitor patients with diabetes, and recall patients for cervical smears.
  • Clarify the leadership structure and ensure there is leadership capacity to deliver all improvements and ensure that systems are in place to support good practices. Where patient care and changes to process are discussed, ensure that the practice is able to review these decisions.
  • Develop systems to consult patients and review their feedback, including feedback provided about GP consultations in the national patient survey.
  • Ensure that a business plan is developed for the practice and share this with staff.

The areas where the provider should make improvement are:

  • Consider formally discussing and documenting any discussions about NICE guidelines and best practice.

  • Ensure that all actions from the last infection control audit are taken forward and that a cleaning schedule is implemented.

  • Ensure that proof of identification is retained in staff files.
  • Consider formalising the induction process.
  • Consider working with the CCG to review the needs of the local population.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

28 August 2013

During a routine inspection

We observed that reception staff were available to assist people in a timely manner, and were professional and polite. The reception area was separate from the waiting area, which meant that privacy was maintained as people checked in for their appointments. It also meant that people could not hear what was said when staff were on the phone.

We found that there were appropriate infection control measures in use at the practice and that medicines were adequately managed. We also found that people were protected from the risk of abuse because procedures were in place at the practice for safeguarding children and vulnerable adults, and staff demonstrated that they were aware of these procedures.