Archived: Birmingham

Updated 27 December 2018

Nomad Travel Clinic in Birmingham is located on the second-floor purpose built station in Piccadilly Arcade, 105 New Street, Birmingham, B2 4EU. The service is accessed by lifts and stairs, which is situated within Costworld Outdoor Store. Nomad Travel Clinic is fully wheelchair accessible. The private travel clinic is a location for the provider TMB Trading Limited who has owned the Nomad travel stores and clinics since June 2016. TMB Trading Limited provides nine travel clinics across England and Wales. Further information about the service can be found by accessing the website at https://www.nomadtravel.co.uk/

The clinic offers travel health consultations, complicated itineraries, complex health and existing medical conditions; travel and non-travel vaccines, blood tests for antibody screening and travel medicines such as anti-malarial medicines to children and adults. In addition, the service works with Public Health England to deliver post-exposure Rabies vaccination. They also provide travel related retail items. The clinic is staffed by one registered nurse who is a specialist travel health nurse. The clinical team are supported by a clinical co-ordinator and two travel hosts. Nurses see up to 250 clients per month.

The Birmingham clinic is open on Tuesdays between 9.30am and 6pm; Thursdays between 11am and 7.30pm. Fridays and Saturdays opening times are between 9.30am and 6pm. The clinic is closed for lunch between 1pm and 1.45pm Tuesdays, Fridays, Saturdays, and between 3pm and 3.45pm on Thursdays. In addition, Nomad provide a telephone consultation service with specialist travel nurses and have a central customer service team to manage appointment bookings.

We inspected the clinic on the 13 November 2018. Our inspection team was led by a CQC lead inspector. The team included a nurse specialist adviser.

Before visiting, we reviewed a range of information we hold about the service. We also asked the service to complete a provider information request. During our visit we:

• Spoke with the lead nurse who at the time of our inspection was the CQC registered manager.
• Spoke to the clinical operations manager who at the time of our inspection was the nominated individual. (A nominated individual is a person who is registered with the Care Quality Commission to supervise the management of the regulated activities and for ensuring the quality of the services provided).
• Looked at information the clinic used to deliver care and treatment plans.
• Reviewed the action plan submitted in response to the February 2018 inspection findings.
• Reviewed comment cards where clients and members of the public shared their views and experiences of the clinic.

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 27 December 2018

We first carried out an announced comprehensive inspection in February 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led. We found that the service was not providing safe and well-led care in accordance with the relevant regulations. As a result, we issued requirement notices as legal requirements were not being met and asked the provider to send us a report of what actions they were going to take to meet legal requirements. The full comprehensive report can be found by selecting the ‘all reports’ link for Birmingham on our website at www.cqc.org.uk

This inspection was an announced comprehensive follow up inspection carried out on 13 November 2018 to check whether the providers had taken action to meet the legal requirements’ as set out in the requirement notices. The report covers our findings in relation to all five key questions.

Our findings were:

Are services safe?

We found that this service was 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 providing well-led care in accordance with the relevant regulations.

Background

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.

Care Quality Commission (CQC) inspected the service on 20 February 2018 and asked the provider to make improvements regarding control measures to ensure risks were as low as reasonably possible such as reducing the spread of health care associated infections. Staff who carried out chaperoning duties did not receive a Disclosure and Barring Service (DBS) check in line with the service chaperoning policy. We checked these areas as part of this comprehensive inspection and found this had been resolved.

This location is registered with CQC, under the location name Birmingham Travel Clinic, in respect of the provision of advice or treatment by, or under the supervision of, a medical practitioner, including the prescribing of medicines for the purposes of travel health. The provider is TMB Trading Limited and is operated as a Nomad Travel clinic in Birmingham. It is a private clinic providing travel health advice, complex health and existing medical conditions, travel and non-travel vaccines, blood tests for antibody screening and travel medicines such as anti-malarial medicines to children and adults. In addition, the clinic holds a licence to administer yellow fever vaccines.

The clinic is registered with the Care Quality Commission under the Health and Social Care Act 2008 to provide the following regulated activities: Diagnostic and screening procedures; Transport services, triage and medical advice provided remotely and Treatment of disease, disorder or injury. The lead 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.

As part of our inspection we also asked for Care Quality Commission comment cards to be completed by clients prior to our inspection. We received 48 completed comment cards which were all positive about the standard of care received. Clients told us the care and treatment they received was great, efficient and caring with all staff being polite, informative, respectful and helpful. Clients said that staff are very professional and approachable.

Our key findings were:

• The service had systems to respond to and learn from safety incidents so that they were less likely to happen.
• Since our previous inspection, control measures in areas such as infection control, recruitment checks and transportation of vaccines to ensure risks were as low as reasonably possible had been reviewed and changes implemented. We saw evidence of control measures being operated effectively.
• The provider routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines and up to date travel health information.
• Each client received individualised travel health information including additional health risks related to their destinations and a written immunisation plan specific to them.
• The provider understood the learning needs of staff and explained staff were provided with protected time and training to meet them.
• Staff treated clients with compassion, kindness, dignity and respect. Care Quality Commission comment cards completed by clients prior to our inspection were all positive about the standard of care received. For example, clients felt the nurses and non-clinical team were caring, efficient, professional and knowledgeable.
• The service took complaints and concerns seriously and responded to them appropriately to improve the quality of care. The provider was aware of the requirements of the duty of candour.
• Completed CQC comment cards and satisfaction surveys carried out by the provider showed that clients were able to access care and treatment from the service within an appropriate timescale for their needs.
• There were clear responsibilities, roles and systems of accountability to support governance and management arrangements. The management of risk had been improved since our previous inspection.

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

• Review the support for clients who did not have English as a first language.
• Review further action that may be available to clients should they not be satisfied with the response to their complaint.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice