This service is rated as Good overall.
The key questions are rated as:
Are services safe? – Requires improvement
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 The London Travel Clinic at Wandsworth as part of our inspection programme. The London Travel Clinic at Wandsworth 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 16 July 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 risk assessed the need for all recommended emergency medicines and not all emergency equipment on site was ready for use, the service had not taken appropriate action to ensure vaccines were safe to use and infection control risks and those associated with legionella had not been assessed. In addition; there was no ongoing programme of clinical improvement activity, there was no mechanism in place to gather, assess and act on patient feedback, there were no documented business continuity plans in place and there were no clear governance arrangements for the undertaking of safety risk assessments and checks for the premises, fire safety and infection control, legionella, the management of medicines, waste management and safeguarding.
At this inspection we found that most of these concerns had been resolved; however, the provider was not monitoring risks associated with legionella, the systems and processes around the management of fire were not sufficient and two patient group directions (PGDs) had expired.
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.
Five patients provided feedback to CQC about the service. All patients said that staff provided helpful advice and were friendly and welcoming.
Our key findings were:
- The provider had systems in place in relation to safeguarding.
- Some risks were not adequately mitigated. For example legionella temperature monitoring was not being completed, there was no information available regarding the service’s fire marshals or assembly point.
- Appropriate emergency equipment was available on site.
- There were systems in place to report and discuss significant events.
- There were systems in place to respond to safety alerts and most medicines were issued in line with legislation and guidance. However we found that two Patient Group Directions (PGDs) had expired.
- 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 must make improvements as they are in breach of regulations are:
- Ensure that care and treatment is provided in a safe way.
The areas where the provider should make improvements are:
- 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