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Inspection report

Date of Inspection: 20 February 2014
Date of Publication: 20 March 2014
Inspection Report published 20 March 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 20 February 2014, talked with people who use the service and talked with carers and / or family members. We talked with staff and reviewed information given to us by the provider.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Most people that we spoke with told us they were happy with the treatment they had received, and that the doctor had involved them in the planning and delivery of their care. One person told us that the doctor was "professional and very good”. Another person stated that “the doctor was rushed [during the appointment] and did not explain much information at the initial appointment. The eight treatment records that we looked at showed that people received vaccinations, immunisations and / or medical advice after an examination of their needs. This included a review of a person’s medical conditions, and travel information in relation to the country of visit and length of stay. However, in some people’s records we found that verbal discussions held between the doctor and person using the service were not always recorded to ensure an audit trail was maintained of the treatment planning that took place. We saw that some people were also referred to the clinic by their GP and hospital departments, and a clinical screening assessment was undertaken by the clinical staff to ensure that suitable services could be offered.

Care and treatment was planned and delivered in a way that ensured people’s safety and welfare. The practice manager told us it was the provider's policy to ensure that people who received treatment were asked to provide written details of their medical history, including their current medication and any allergies; to ensure that the doctor did not recommend and / or deliver treatment that might impact on a person’s health. We found people provided this information in a travel risk assessment form which was reviewed with them by the doctor during consultation. One doctor that we spoke with showed us two records to evidence they had worked in co-operation with other health professionals to risk assess the suitability of vaccinations before they were administered to the person’s using the service. For example, we saw that the doctor had requested from a consultant written confirmation of a person’s recent blood test results and responsiveness to anti-retroviral treatment (ARV) to inform their clinical decision to administer the yellow fever vaccination. In another example, the doctor had liaised with a child’s parent, general practitioner (GP) and paediatric respiratory clinical specialist to assess if there were any risks of the child receiving varicella vaccine due to their diagnosis of lung disease. Where risks were identified, for example a person with severe allergy to egg, vaccinations such as yellow fever were not administered. This showed that the provider had a system in place to identify, assess and manage risks to the health, safety and welfare of people using the service.

There were arrangements in place to deal with foreseeable emergencies. The provider had appropriate resuscitation equipment in place; this included a defibrillator, an emergency drugs box and anaphylaxis kits. These were checked on a monthly basis by the practice manager to ensure that they were safe to use and accessible in the event of an emergency. We found all emergency drugs were in date and suitable for use. Staff we spoke with knew what actions to take in the event of an emergency such as contacting the doctor and / or emergency services, and clinical staff records we looked at showed doctors had up to date basic life support training. The provider had a business continuity plan in place which included loss of utilities, adverse weather and staff absences. At the time of our inspection, this plan was being reviewed to ensure that current arrangements were appropriate for dealing with emergencies.