A GP practice has been given a formal warning for failing to meet national standards on cleanliness and infection control.
Such action would range from being prevented from providing some services, to fines or even prosecution.
The Care Quality Commission (CQC) did a routine inspection of the centre, which has 11 doctors and seven nurses, in December.
It was given until February 7 to bring cleanliness and infection control up to the required standard.
Inspectors are due to make an unannounced return visit to the centre.
Their report said: “People were not always protected from the risk of infection because appropriate guidance had not been followed.
“We have judged that this has a moderate impact on people who use the service and have taken enforcement action against this provider. “Effective systems were not always in place to reduce the risk and spread of infection.”
The inspectors said most of the surgery was clean and tidy and protective equipment and hand gel was available. But they “saw a number of items which were unclean.
"These included toys in the waiting area and two baby changing mats in consultations rooms. Some waiting area chairs were torn and could not be cleaned properly, and carpets in some consultation rooms were stained.
“This all meant that appropriate standards of cleanliness and hygiene were not maintained.”
Boxes for blades and needles were not signed as such, which meant there was no audit trail to show proper processes, to reduce the risk of injury and infection, had been followed.”
There were no spillage kits for cleaning up body fluids and pedal bins used for storing clinical waste did not have the appropriate liners.
“We also saw some of the pedals were not working, this meant staff had to manually open the lid to dispose of clinical waste. This increased the risk of the spread of infections.”
The inspectors also found there was no infection control audit program e.
Lincial Commissiong Group, whioch iversees GPs, A spokesman for North Durham Clinical Commissioning Group (CGC), which oversees GPs, said: “NHS North Durham CCG is committed to improving quality in general practice.
“The CCG has been in touch with the practice and has received assurance that they have taken the necessary action promptly."