• Doctor
  • Independent doctor

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

Overall: Requires improvement read more about inspection ratings

93 Water Lane, Leeds, West Yorkshire, LS11 5QN (0113) 467 9506

Provided and run by:
Clari Health Ltd

All Inspections

17/10/2019

During a routine inspection

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

31 January 2019

During a routine inspection

We carried out an announced comprehensive inspection on 31 January 2019 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 in some areas this service was not providing safe care in accordance with the relevant regulations. The impact of our concerns is minor for clients using the service, in terms of the quality and safety of clinical care. The likelihood of these occurring in the future is low as they have been put right post-inspection.

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 in some areas this service was not providing well-led care in accordance with the relevant regulations. The impact of our concerns is minor for clients using the service, in terms of the quality and safety of clinical care. The likelihood of these occurring in the future is low as they have been put right post-inspection.

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.

The service provides travel health advice and travel vaccinations. This service had not been previously inspection by the Care Quality Commission (CQC).

The registered nurse who delivered the service based at Leeds 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 15 CQC client comment cards. Fourteen were positive regarding the information and service provided and said that staff were friendly, helpful and caring. There was one mixed comment regarding having to wait to gain access to the building.

Our key findings were:

  • There were arrangements in place to keep clients safeguarded from abuse. However, a nominated safeguarding lead, who had undertaken the appropriate level of safeguarding training, had not been identified at the time of our inspection.
  • There were some policies in place to support service delivery and safe care. However, not all were dated or had a recorded review date. There were some policies not in place that we would expect to see, such as those relating to chaperones, client consent or lone working.
  • There was a recruitment process in place, including ensuring appropriate checks were undertaken prior to employment.
  • The premises were clean, tidy and fit for purpose to deliver the service. However, an infection prevention and control lead had not been nominated at the time of our inspection.
  • There were systems in place for the management of medicines and vaccines. However, it was noted that in the fridge some vaccines were stored inappropriately and there was evidence of overstocking.
  • The nurse knew how to deal with medical emergencies. However, there was no emergency equipment in the clinic nor had a risk assessment been carried out in relation to the decision not to keep them on site.
  • 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.
  • The nurse had not completed some areas of training, such as the appropriate level of safeguarding, basic immunisation, IPC, fire safety and training in the Mental Capacity Act 2005.
  • Clients’ records were stored in line with the General Data Protection Regulation (GDPR). However, it was unsure on the day of inspection whether staff had received training in data protection and information governance.
  • Feedback from clients was positive about the service they received. Reviews contained praiseworthy comments of the nurse who delivered the service.
  • Information was submitted to NaTHNaC in line with guidance, such as that relating to yellow fever vaccinations.
  • The provider showed a commitment to learning and improving the service. The majority of areas which had been raised as a concern or area of action had been addressed by the provider both during the inspection and post-inspection. We received evidence to support this.
  • Evidence was provided post-inspection, before the report was written, that showed the provider had resolve the majority of the issues raised.

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

  • Review and improve the stocking and storing of vaccines in the fridge.
  • Review and update the training requirements for staff working in the service.
  • Review and improve the scope and range of risks assessments required to support safe provision of the service.

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice