Balfour Medical Centre

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

At our last assessment, we rated this key question as inadequate. At this assessment, the rating is Good. This meant people were safe and. protected from avoidable harm. During our assessment of this key question, we found incidents were investigated openly and transparently. Actions were recorded and learning was shared with staff to mitigate the future likelihood of incidents reoccurring. Regular staff meetings were held which included clinical and non-clinical staff and minutes showed that incidents were discussed, the learning was shared along with any changes that were implemented to improve processes. Staff were confident in responding to safeguarding concerns and had received training relevant to the role. People received co-ordinated and joined up care when transitioning between healthcare services through the effective management of referrals, correspondence between providers and regularly reviewed local secondary care pathways. We saw there was no backlog in referrals and there were processes in place to follow-up actions when necessary. We looked at recruitment processes for 3 clinical and 3 non-clinical staff. Recruitment checks were carried out in accordance with regulations and assurances were provided relating to the fit and proper persons employed. The practice ensured workforce planning arrangements were in place and staff were supported in their roles, including training, appraisal and relevant supervisions to provide safe care and treatment. During our clinical searches, we found a small number of patients had not received the required monitoring, but the practice was aware of some of these and the remainder were contacted during the inspection.

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.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Whole staff meetings took place regularly with clinical and non-clinical staff attending. During these meetings, significant events and learning were discussed to improve care and treatment for others. Patients felt supported to raise concerns and felt staff treated them with compassion and understanding. Lessons were learnt to continually identify and embed good practice.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. The practice worked with other providers to deliver shared care and patients told us they appreciated how they received test results in a timely manner. There was a process in place to check all patients with 2 week wait referrals had been referred appropriately and received their appointment with a specialist. Feedback we received from patients reflected this.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations. There were examples which showed effective multi-agency work when a safeguarding concern was identified at the practice. All organisations were able to view and add information to a safeguarding record online, which meant that the information available was always the most current and up to date.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Emergency equipment was available and maintained. Staff could recognise a deteriorating patient and knew of action to take. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The practice had effective arrangements to monitor the safety and upkeep of the premises. We observed the practice, including facilities and equipment to be well-maintained, accessible and suitable for the intended purpose. The practice had maintenance records for checks of the fire alarm system, fire extinguishers and emergency lighting. Health and safety risk assessments of the premises and equipment had been completed and risks identified had been addressed. Portable appliance testing was completed annually to ensure equipment was safe to use.

The practice made sure there were enough qualified, skilled and experienced staff, who received regular effective support, supervision and professional development. There was a range of clinical and non-clinical roles within the practice. We found training was up to date, learning needs and development of staff were managed appropriately, and staff were working within their agreed areas of competence. Safe recruitment practices were followed and were in line with current legislation and guidance.

The practice had processes in place to assess and manage the risk of infection. The practice had an infection prevention and control (IPC) policy in place and a designated infection, prevention and control lead. All staff had attended relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

The practice had systems to manage and respond to safety alerts and medicine recalls. The practice completed regular clinical audits to identify and follow up patients who were affected. Regular medicines reviews were carried out to ensure patient medicines were appropriate to their needs. Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms. Staff received regular training, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely. Staff followed protocols to ensure they prescribed all medicines safely, and to ensure people received all recommended medicines reviews and monitoring. Medicines were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. Staff stored medical gases safely and completed safety risk assessments. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. We identified a small number of patients who had not received the required monitoring, and clinical staff were aware of some of these patients. The remainder of these patients were contacted during the inspection and were either in progress or resolved. Staff ensured they prescribed medicines appropriately to optimise care outcomes. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment. Examples of completed two-cycle audits included, renal function monitoring for patients with chronic kidney disease, health checks, and the monitoring of patients who were prescribed Mirabegron (used to treat symptoms of an overactive bladder).