Archived: Clari Health Leeds Travel Clinic Also known as Clari Health Leeds

Updated 9 January 2020

Clari Health Ltd is the provider of Clari Health Leeds Travel Clinic which is located on the second floor of the This Is My: building, 93 Water Lane, Leeds, West Yorkshire LS11 5QN. The location is a short walk from Leeds train station. There is free onsite car parking. Upon entering the premises, there is a large waiting area on the ground floor. Clients accessing the travel clinic have the option of using the stairs or a lift.

Clari Health Ltd consists of five other CQC registered locations located in Birmingham, Liverpool, London, Tyne and Wear and South Manchester. As part of this inspection we did not visit any of the other locations.

The service provides a personalised risk assessment, travel health advice and travel vaccinations, including those for the prevention of yellow fever. Seasonal influenza vaccination is also provided to those who are unable to receive it from their NHS GP. Services are provided by two female registered nurses who are trained in travel health (one of whom is the registered manager). The nurses are supported by a qualified doctor (medical director) and a management consultant, who are contracted by the provider.

Clients are required to make an appointment either online via the website or by contacting the clinic by telephone. The service does not accept walk-in appointments. Excluding bank holidays, the opening hours of the clinic are:

Tuesday 10am to 3pm

Wednesday 10am to 3pm

Thursday 8am to 8pm

Friday 8am to 3pm

Saturday 8am to 2pm

The service is registered with the CQC under the Health and Social Care Act 2008 to provide the following regulated activities:

• Diagnostic and screening procedures
• Treatment of disease, disorder or injury

How we inspected this service

Before visiting, we reviewed a range of information which was provided pre-inspection, that which we hold about the service and the provider’s website and service users’ comments available via the internet.

During the inspection we:

• Spoke with staff and the registered manager of the service.
• Reviewed key documents which support the governance.
• Looked at information the service used to deliver care and treatment.
• Reviewed comment cards where patients shared their views and experiences of the service.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 9 January 2020

We carried out an announced comprehensive inspection at Clari Health Leeds Travel Clinic on the 17 October 2019, as part of our inspection programme to rate independent health providers. We carried out this inspection under Section 60 of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014, as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations.

Clari Health Leeds Travel Clinic provides a travel health advice and travel vaccination service, including those for the prevention of yellow fever. Seasonal influenza vaccination is provided to those who are unable to receive it from their NHS GP.

The clinical manager 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 of the Health and Social Care Act 2008 and associated Regulations. At the time of our inspection there was an application in process to add an additional registered manager to share the position with the current registered manager.

On the day of inspection, we received 28 completed Care Quality Commission (CQC) comment cards which were all positive. For example, clients said they found it easy to access services with flexible appointments; staff were professional, friendly, helpful and provided wide-ranging travel health advice. Clients said they would recommend the service to others.

Our key findings were :

• There were arrangements in place to keep clients safeguarded from abuse. Clinicians had completed safeguarding training appropriate to their role and demonstrated awareness of what to do if they had concerns regarding the wellbeing of a child or vulnerable adult.
• There were some policies in place to support service delivery, however, we were not assured that staff were aware of the most up-to-date policy to use. Additionally, in the event of an emergency, some policies would not have necessarily directed staff to the most appropriate course of action, such as those relating to fire safety.
• On the day of inspection there was no clear documentation regarding the management of the vaccine fridge temperature when it was out of range.
• The provider had not undertaken any fire or health and safety assessments of the location, as identified in their risk policy. There were no facilities to support disabled or clients with poor mobility down the stairs in the event of a fire. Staff had not participated in a fire evacuation drill at the premises.
• There was no documented evidence which demonstrated that staff were asked about their occupational health immunity status, such as varicella (chickenpox) and MMR. There were no clear processes should a member of staff refuse to have immunisation.
• Although there were recruitment processes in place, these were not always followed.
• There were systems and processes in place to support infection prevention and control. These included cleaning schedules and audits.
• The service participated in quality improvement activity. Clients’ needs were assessed, and treatment delivered in line with current legislation, standards and guidance, such as National Travel Health Network and Centre (NaTHNaC) travel guidance.
• Clients’ records were stored in line with the General Data Protection Regulation (GDPR). Staff demonstrated awareness of data protection; and we saw that training had been scheduled as part of the staff induction programme.
• Clinicians demonstrated awareness of how to obtain consent to care and treatment in line with legislation and guidance.
• On the day of inspection, staff did not demonstrate a clear understanding of incident reporting. We were informed of an incident which had not been recorded as such.
• Completed Care Quality Commission (CQC) comment cards as well as feedback received through online surveys were positive about the level of care as well as quality of service received.
• There was limited evidence to demonstrate organisational oversight. It was not clear who had overall responsibility to manage areas such as incidents, complaints and risk assessments. Policies related to departments, such as human resources, but there was no evidence to support such a department existed.
• Patient Group Directions (PGDs) had not been managed appropriately. Staff did not demonstrate a good understanding of the legalities regarding these documents.

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

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

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Improve the recording of vaccine fridge temperatures and evidence where any action has been undertaken in the event of an abnormal reading.
• Reassure themselves that all recruitment processes are followed prior to employment of staff.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care