We carried out an announced comprehensive inspection on 4 June 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 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.

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.

Medical Advisory Service for Travellers Abroad (MASTA) Travel Clinic Birmingham is a private clinic providing travel health advice, travel and non-travel vaccines and travel medicines such as anti-malarial medicines to children and adults. In addition, the clinic holds a licence to administer Yellow fever vaccines and also provides non- travel vaccines. This location is registered with the Care Quality Commission (CQC) 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 clinic is registered with the CQC under the Health and Social Care Act 2008 to provide the following regulated activities: Treatment of disease, disorder or injury; Diagnostic and screening procedures. 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.

Our key findings were:

• Although the clinic had systems in place to manage risk so that safety incidents were less likely to happen and we saw evidence of actions taken to prevent risks to clients, the process for reporting incidents were not consistently followed.
• Clinical waste was not segregated and disposed of in a way which enabled the waste to be classified correctly so that it was managed appropriately upon collection.
• 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, as well as research carried out by MASTA medical consultants and up to date travel health information.
• Each client received an individualised travel health brief containing a risk assessment, health information including additional health risks related to their destinations and a written immunisation plan specific to them.
• Staff involved and treated patients with compassion, kindness, dignity and respect. MASTA Birmingham comment cards completed by clients who accessed the service in the last 12 months were all positive about the standard of care received.
• There was a leadership structure with clear responsibilities and systems of accountability in place to support the governance arrangements.
• Staff we spoke with felt supported by the leadership team and explained how they accessed support from clinical leads; however, the system to support communication and shared learning within the nursing team was not embedded.
• The provider was aware of the requirements of the duty of candour.

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

• Review the process for monitoring staff compliance with policies and procedures to ensure processes such as incident reporting are being followed appropriately.
• Review the waste management policy to ensure safe management of healthcare waste.
• Review systems of engagement with the wider nursing network to ensure support is available and learning is being shared.