• Doctor
  • Independent doctor

Archived: Victoria Also known as London Travel Clinic

Overall: Good read more about inspection ratings

Level 19, Portland House, Bressenden Place, London, SW1E 5RS

Provided and run by:
London Travel Clinic Limited

All Inspections

16/08/2019

During a routine inspection

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Victoria as part of our inspection programme. Victoria is part of The London Travel Clinic which provides travel immunisations, treatment and advice to fee paying patients.

We had previously inspected this service as part of our unrated programme of independent health inspections. At our last inspection undertaken on 20 August 2018 we found that the service was in breach of regulation 12 (safe care and treatment) and regulation 17 (good governance) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At that inspection we found that the provider had not adequately mitigated risks associated with infection control and fire safety and the service had not assessed the need for all emergency medicines. In addition we found that there was no ongoing quality improvement activity programme, there was no mechanism in place to review and act on patient feedback and the business continuity plan, medicines policy and policies related to information governance were not specific to the site.

At this inspection we found that these concerns had been resolved.

The clinical nurse lead for the service 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.

One patient provided feedback to CQC about the service. The patient said that the treatment provided was quick and efficient and that their needs were met.

Our key findings were:

  • The provider had systems in place in relation to safeguarding.
  • Risks were adequately assessed, addressed or mitigated.
  • Appropriate emergency equipment was available on site and staff knew what to do if a patient presented with symptoms of sepsis.
  • There were systems in place to report and discuss significant events.
  • Medicines were appropriately managed and there were systems in place to respond to safety alerts.
  • Care and treatment provided was effective and met patient needs.
  • There were systems to review consultations, feedback to staff and implement improvements where needed.
  • Feedback from patients was positive about access to treatment and the care provided and there was a system for managing complaints.
  • Services were designed to respond to the needs of patients.
  • Leadership was visible and staff said that they felt happy to raise concerns or issues that arose.
  • Governance systems were present in most areas although there were some instances where the provider did not have effective systems in place to oversee risk.

The areas where the provider should make improvements are:

  • Consider ways to better accommodate patients with accessibility needs.
  • Include details of all staff working at the site in the business continuity plan.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

20 August 2018

During a routine inspection

We carried out an announced comprehensive inspection on 20 August 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 not providing 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 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.

Dr Stephen Alex Bobak is the registered manager at Victoria. 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.

Victoria is an independent travel clinic in London and provides travel health services including vaccinations, medicines and advice on travel related issues to both adults and children. Prior to our inspection patients completed CQC comment cards telling us about their experiences of using the service. There were nine responses, all providing wholly positive feedback about the service.

Our key findings were:

  • There were limited systems in place to keep patients safeguarded from abuse. Information about who to contact with a concern was accessible to staff and staff had received safeguarding training. However, the service did not have a safeguarding policy which was tailored to the site and one member of staff did not know who the service’s safeguarding lead was.
  • Not all risks were assessed or well-managed.
  • The premises appeared visibly clean; however, no infection control audits had been completed. The service had taken action to mitigate risks associated with infection control.
  • The service had some systems in place to manage medical emergencies although had not risk assessed the need for recommended emergency medicines and we were told that two medicines were not currently available.
  • There was information available to tell patients how to provide feedback but this did not specifically refer to complaints and the service did not have an effective system to gather or act on patient feedback.
  • The service had systems in place to respond to incidents. When incidents did happen, the service learned from them and improved.
  • 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 no evidence of activity which aimed to improve the quality of clinical care provided.
  • The appointment system reflected patients’ needs. Patients could book appointments when they needed them.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Staff felt involved and supported and worked well as a team.
  • There was a lack of effective managerial oversight and some areas of governance were not sufficient to ensure safe care and that quality of services improved. There were different versions of policies and procedures, one set for Vaccination UK Limited (who recently acquired the provider), one for The London Travel Clinic and a separate standard operating procedure for the site. Staff were unclear as to which set of policies they should be using and none had been completed with all the required information.

We identified regulations that were not being met and the provider must:

  • 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.

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

  • Advertise the service’s complaints procedure and keep appropriate records of complaints received.

Establish processes for sharing information with a patient’s GP in absence of patient consent.  

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice