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360 Health- London Bridge Good

Reports


Inspection carried out on 11 November 2019

During a routine inspection

We carried out an announced comprehensive inspection at 360 Health-London Bridge on 11 November 2019. The service was previously inspected on 25 May 2018. In accordance with CQC policy at the time, this service was not rated following that inspection. We found whilst most of the standards were being met, the systems to manage risks at the service were not always effective and there was limited evidence of quality improvement. These issues impacted negatively on the overall standard of governance at the service. A Requirement Notice was made in relation to breaches of regulation 17 of the Health and Social Care Act 2008 (Regulate Activities) Regulations 2014. We also said the provider should formally document risk assessments and leadership roles within the practice policies. We checked these areas as part of this comprehensive inspection and found they had all been resolved.

360 Health-London Bridge is a travel clinic which provides a range of travel vaccinations, medical assessments and health screening offered on an appointment and a same-day, walk-in basis. The service is operated by 360 Health, also known as London Vaccination Clinic. They own seven sites across London which are satellite sites, London Bridge being the main site for the purposes of oversight, management and governance. We did not visit the other sites which operate at differing times of the day and year, depending on patient demand, some consisting of a single room.

The leadership team at the clinic includes the co-founder and chief executive officer who is a nurse prescriber and the medical director who is also 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. There is also an operations director who manages the day to day running of the service.

Clinical services are provided by two nurses, one being the lead nurse, who are overseen by the co-founder and medical director.

Feedback we received through 21 comment cards completed by people who used the service were positive and a patient we spoke with. One commented about some difficulty finding the clinic but was positive about their experience of using the service.

Our key findings were

:

  • There was a system in place for acting on significant events.
  • Risks associated with the premises and the delivery of care and treatment were well managed.
  • There were arrangements in place to protect children and vulnerable adults from abuse.
  • Care and treatment was provided in accordance with current guidelines.
  • Patient feedback indicated that staff were compassionate, the care provided of a high standard and that it was easy to access appointments.
  • The service had a system to receive and respond to complaints.
  • There was a clear vision and strategy and staff spoke of an open and supportive culture. There was effective governance to ensure risks were addressed and patients were kept safe.

Dr Rosie Benneyworth BM BS BMedSci MRCGP


Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 25 May 2018

During a routine inspection

We carried out an announced comprehensive inspection of Destination Health @ London Bridge on 29 May 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 providing safe care in accordance with all 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.

Destination Health @ London Bridge provides independent travel health advice and medicines in Central London. Prior to our inspection patients completed CQC comment cards telling us about their experiences of using the service. Seven people provided wholly positive feedback about the service.

Our key findings were:

  • The systems to manage risks were not always effective.
  • The service had systems in place to respond to incidents and take action to learn and make improvements.
  • 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 limited evidence of quality improvement activity.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Services were provided to meet the needs of patients.
  • Patient feedback for the services offered was positive.
  • There were clear responsibilities, roles and systems of accountability, although 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:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

We also identified areas where the provider should take action:

  • Formally document assessment of risk.
  • Document leadership roles within practice policies.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection carried out on 16th December 2016

During a routine inspection

We carried out a focussed inspection on 15th December 2016 to ask the service the following key questions; Are services safe?

Our findings were:

Are services safe?

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

Background

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.

CQC inspected the service on 17th December 2015 and asked the provider to make improvements regarding the gaps in the systems and processes which operated to effectively prevent abuse of service users (safeguarding). We checked these areas as part of this focussed inspection and found this had been resolved.

London Vaccination Clinic at London Bridge provides a private travel vaccination service and advice on immunisation for travellers (both children and adults). The clinic operates from one room and has at least one member of clinical nursing staff present at a time. The clinic also employs a lead nurse and six members of nursing staff who rotate between different provider sites.

The clinic is open from 10:00am to 8:00pm, Monday to Friday, and from 10:00am to 16:00pm on Saturdays.

The Clinical Director 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.

Our key findings were:

  • There were adequate systems and processes in place which operated to effectively prevent abuse of service users, including children.

Inspection carried out on 17th December 2015

During a routine inspection

We carried out an announced comprehensive inspection on 17 December 2015 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 some 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 providing well-led care in accordance with the relevant regulations.