The Care Quality Commission
  • Doctor
  • Independent doctor

Archived: Soho Square

Overall: Good read more about inspection ratings

18 Soho Square, London, W1D 3QL (020) 7659 2110

Provided and run by:
London Travel Clinic Limited

All Inspections

17 March 2020

During an inspection looking at part of the service

We carried out a focused desk-based follow up inspection at London Travel Clinic Soho Square. We had previously carried out a rated comprehensive inspection on 8 July 2019 and found that the service was in breach of regulation 12 (safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were:

  • There were systems in place to assess, address and mitigate the risks associated with fire safety and legionella.
  • Medical equipment had been calibrated and PAT to ensure they were safe to use.
  • The provider had arrangements in place to accommodate patients with accessibility needs.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

To Be Confirmed

During a routine inspection

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Soho Square as part of our inspection programme. Soho Square is part of The London Travel Clinic which provides travel immunisations, treatment and advice to fee paying patients.

We had previously inspected this service as part of our unrated programme of independent health inspections. At our last inspection undertaken on 4 July 2018 we found that the service was in breach of regulation 12 (safe care and treatment) and regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At that inspection we found that the provider had not adequately mitigated risks associated with infection control, non-clinical staff had not completed the requisite training, there was a lack of quality improvement activity, the complaints system was not advertised and there was no mechanism in place for gathering patient feedback. There was a lack of oversight in key areas of risk and safety and there was no business continuity plan.

At this inspection we found that most of these concerns had been resolved however the provider still did not have adequate oversight of risk management activities undertaken by third parties. It was not clear that all site-specific recommendations were followed up to ensure safety.

The clinical nurse lead for the service is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Two patients provided feedback to CQC about the service. Both patients said that the treatment provided was excellent and met their needs.

Our key findings were:

  • The provider had systems in place in relation to safeguarding.
  • Some risks were not adequately assessed, addressed or mitigated. For example, the provider did not have adequate oversight of risk management activities undertaken by third parties including in relation to fire safety and legionella.
  • Appropriate emergency equipment was available on site. Staff understood their responsibilities to manage emergencies and to recognise those in need of urgent medical attention.
  • There were systems in place to report and discuss significant events.
  • Medicines were appropriately managed and there were systems in place to respond to safety alerts.
  • Care and treatment provided was effective and met patient needs.
  • There were systems to review consultations, feedback to staff and implement improvements where needed.
  • Feedback from patients was positive about access to treatment and the care provided and there was a system for managing complaints.
  • Services were designed to respond to the needs of patients.
  • Leadership was visible, and staff said that they felt happy to raise concerns or issues that arose.
  • Governance systems were present in most areas although there were some instances where the provider did not have effective systems in place to oversee risk.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure that care and treatment is provided in a safe way.

The areas where the provider should make improvements are:

  • Consider ways to better accommodate patients with accessibility needs.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

04 July 2018

During a routine inspection

We carried out an announced comprehensive inspection on 04 July 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Dr Stephen Alex Bobak is the registered manager at Soho Square. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Soho Square is an independent travel clinic in London and provides travel health services including vaccinations, medicines and advice on travel related issues to both adults and children. Prior to our inspection patients completed CQC comment cards telling us about their experiences of using the service. There were 13 responses, all providing wholly positive feedback about the service.

Our key findings were:

  • There were limited systems in place to keep patients safeguarded from abuse. Information about who to contact with a concern was not accessible to staff. Clinical staff had received safeguarding training however not all non-clinical staff had received training on safeguarding children relevant to their role.
  • There was minimal evidence that risks were assessed and well-managed; the service did not have an effective system of health and safety and premises checks.
  • The premises were clean; however, no infection control audits had been completed and infection control risks were present which had not been addressed.
  • Procedures for managing medical emergencies were lacking.
  • Policies and procedures were generic and did not reflect day to day practice at the service.
  • The complaints system was not advertised but the service would provide patients with an email address which they could contact after their appointment, to provide feedback.
  • The service had systems in place to respond to incidents. When incidents did happen, the service learned from them and improved.
  • The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines. However, there was no evidence of activity which aimed to improve the quality of clinical care provided.
  • The appointment system reflected patients’ needs. Patients could book appointments when they needed them.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • The service did not have an effective system to gather patient feedback.
  • Staff felt involved and supported and worked well as a team.
  • There was a lack of effective managerial oversight and some areas of governance were not sufficient to ensure safe care and that quality of services improved.

We identified regulations that were not being met and the provider must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

  • Establish processes for sharing information with private patient’s GP in absence of patient consent.
  • Review and improve, as far as is practicably possible, the accessibility of the premises for patients with mobility difficulties.