Compliance hub for GP surgeries and care homes

CQC inspects GP practices, care homes and clinics against five key questions: are services safe, effective, caring, responsive and well-led? Inspectors look for evidence, so the practices that do well keep it organised and up to date all year round, not just in the weeks before a visit.

• Keep an inspection folder with a section for each key question
• Make sure policies are reviewed on schedule and version-controlled
• Keep training, appraisal and recruitment records complete
• Record checks on emergency kit, fridges and equipment
• Learn from significant events and complaints, and show what changed

Every registered provider must have systems to prevent and control infection. In practice that means a named IPC lead, clear policies, regular audits, clean clinical rooms, the right PPE and good hand hygiene from everyone.

• Name an IPC lead and keep their training up to date
• Audit IPC regularly (most practices audit at least once a year) and act on the findings
• Use a cleaning schedule for every clinical room and sign it off
• Stock the right PPE in every room: gloves, aprons and face protection
• Put hand hygiene and spill procedures on the wall where they are needed

Healthcare waste must be segregated at the point it is produced, stored securely and collected by a licensed waste carrier, with the right paperwork kept. The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 also require safer sharps where reasonably practicable, no recapping of needles, and sharps bins placed close to where sharps are used.

• Use colour-coded bags and bins so waste is segregated where it is produced
• Use the right sharps bin for the waste (lid colours show what goes in each)
• Close sharps bins at the fill line, label them and never over-fill
• Store waste securely until collection by a licensed contractor
• Keep waste transfer and consignment notes for as long as required

COSHH means assessing the hazardous substances your team uses, such as disinfectants, cleaning chemicals and some clinical products, and putting controls in place. The supplier’s safety data sheet tells you the hazards and how to handle each product safely.

• List every hazardous substance used and where it is stored
• Keep a current safety data sheet for each one
• Complete a COSHH assessment for each substance or task
• Make sure staff know the controls and have the right PPE
• Review assessments when products or tasks change

Vaccines must be stored between +2°C and +8°C, in a fridge designed for vaccines. National guidance in the Green Book expects the minimum, maximum and current temperatures to be recorded every working day, and a clear plan for what to do if a reading is ever out of range.

• Use a pharmaceutical (vaccine) fridge, never a domestic one
• Record min, max and current temperatures every working day, then reset
• Use a second, independent data logger as a back-up
• Know your cold chain breach procedure and display it on the fridge
• Do not over-fill the fridge: air needs to circulate

Practices are expected to have emergency medicines and equipment that suit the services they provide, kept in date, easy to reach and checked regularly. A defibrillator should be ready to use at all times, with pads and batteries in date.

• Keep a list of your emergency drugs and equipment, with expiry dates
• Check the emergency kit on a regular schedule (many practices check monthly)
• Check the defibrillator regularly (many practices check weekly) and log it
• Make sure oxygen, masks and suction are ready to use
• Keep staff resuscitation training up to date

Spills of blood and body fluids need to be dealt with quickly and safely, by trained staff using the right PPE and products. A spill kit in each clinical area and a clear procedure on the wall make it easy to get right.

• Keep a spill kit in every clinical area and check it is complete
• Follow your local IPC policy for the products to use
• Wear gloves and an apron, and eye protection if splashing is likely
• Dispose of everything as clinical waste
• Record the incident if anyone was exposed

Medical devices such as blood pressure monitors, scales, thermometers and ECG machines need servicing and calibration so that readings can be trusted. Keeping one asset register makes it easy to show that every device is maintained.

• Keep an asset register of every medical device
• Service and calibrate devices in line with the manufacturer’s guidance
• Label each device with its next service date
• Take faulty devices out of use straight away
• Keep certificates for inspections

As the person responsible for your premises, you need a current fire risk assessment, a legionella risk assessment with any control measures carried out, and electrical systems and equipment that are kept safe.

• Have a suitable fire risk assessment and review it regularly
• Have a legionella risk assessment and record any water checks it asks for
• Keep portable electrical equipment safe (PAT testing is a common way to show this)
• Have the fixed wiring inspected (an EICR) at the intervals recommended for your premises
• Keep certificates together for inspection

Hand hygiene is the single most important way to prevent infections spreading. Staff should clean their hands at the right moments, with the right products available at every point of care.

• Put hand sanitiser at every point of care
• Stock soap, paper towels and hand cream at every clinical basin
• Display hand hygiene posters at basins and in clinical rooms
• Include hand hygiene in your IPC audit
• Keep nails short and arms bare below the elbow in clinical areas, in line with local policy