23 October 2019
During a routine inspection
This service is rated as Requires improvement overall. (Previous inspection September 2018 (not rated)).
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? – Requires improvement
We carried out an announced comprehensive inspection at Go Global Vaccinations and Travel Health Clinic on 23 October 2019 as part of our inspection programme.
The travel health specialist nurse 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.
We received 22 comment cards from clients who had used the service. All were positive about the care received. Many clients commented how professional and knowledgeable the travel health specialist nurse was and how quickly they were responded to when they requested information and advice regarding their travel needs.
Our key findings were:
- There were some processes in place to identify and review safety risks and issues, although others had not been identified or considered. For example, there was no infection control audit and we found some infection control issues that would have been identified had an appropriate assessment taken place.
- The process for prescribing using a Patient Specific Direction was not in line with legal requirements.
- Health and safety risks had not been identified or formally assessed and we found some items of equipment had not been calibrated in accordance with manufacturers’ instructions.
- Governance arrangements were inconsistently identified and reviewed, and we found there was little evidence of monitoring, clinical audit or quality improvement activity to ensure services were safe or effective.
- There were appropriate safeguarding arrangements in place to keep clients safe and safeguarded from abuse.
- Client risk assessments were thorough and determined the most up to date travel health recommendations supported by guidance.
- The provider utilised resources and information from reliable and evidence based sources and used these to inform decision making processes.
- Training, regular updates and opportunities to develop had been fully established within effective processes.
- Clients were supported to make decisions and advised where to go for additional sources of support and information, when required.
- Patient feedback was positive about the care and treatment received.
- The provider had considered the needs of the population using the service and offered flexible appointments.
The areas where the provider must make improvements as they are in breach of regulations are:
- 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.
The areas where the provider should make improvements are:
- Develop methods of gaining client feedback to include an assessment of the quality of clinical care received. Also consider how verbal concerns received as feedback can be utilised in analysing patient satisfaction trends.
- Patient feedback should be actively sought. Identify how feedback can be retained for an appropriate length of time.
- Improve how clients can access the complaints process online.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care.