This service is rated as Good overall. (Previous inspection December 2017).

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 MASTA Travel Clinic - Bristol 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.

MASTA Travel Clinic – Bristol is a private clinic providing travel health advice, 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.

This location is registered with CQC under the Health and Social Care Act 2008 in respect of some, (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) but not all, of the services it provides. There are some general exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At MASTA Travel Clinic - Bristol services are provided to clients under arrangements made by their employer with whom the servicer user holds a policy (other than a standard health insurance policy). These types of arrangements are exempt by law from CQC regulation. Therefore, at MASTA Travel Clinic - Bristol we were only able to inspect the services which are not arranged for clients by their employers whom the client holds a policy (other than a standard health insurance policy.

During the inspection we reviewed five completed CQC comment cards which described the service as efficient and staff as caring, efficient, knowledgeable and respectful.

Our key findings were:

• The clinic had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the provider learned from them and improved their processes.
• 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 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 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.
• There was a leadership structure in place with clear responsibilities, roles and systems of accountability to support good governance and management. Staff felt supported by the leadership team and worked well together as a team.
• The provider was aware of the requirements of the duty of candour.

The areas where the provider should make improvements are:

• The provider should consider photographic identification checks for adults with parental responsibility in order to ascertain correct identity.
• The provider should review policies in line with their renewal dates.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection on 21 December 2017 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.

Background

Following our comprehensive inspection of the MASTA Travel Clinic - Bristol on 13 January 2016 the location was not providing safe care in accordance with the relevant regulations. We found the registered nurses who assessed and treated children at the location were not trained to the appropriate competency for safeguarding children. We issued a requirement notice for Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Safeguarding service users from abuse and improper treatment. We checked this area as part of this comprehensive inspection and found the registered nurses had received appropriate training. The service is now meeting this requirement.

There had been other areas identified where the provider could make improvements such as publicising complaint procedures; providing information on chaperone services; labelling and directions on prescribed medicines and making reasonable adjustments for people with physical or sensory disabilities, and people whose first language is not English. We checked these areas as part of this comprehensive inspection and found they had been resolved.

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.

MASTA Travel Clinic – Bristol is a private clinic providing travel health advice, 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. This location is registered with 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 Care Quality Commission under the Health and Social Care Act 2008 to provide the following regulated activities: Diagnostic and screening procedures 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.

Our key findings were:

• The clinic had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the provider learned from them and improved their processes.
• 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 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. Care Quality Commission comment cards completed by clients prior to our inspection were all positive about the standard of care received. They told us the nurses were caring, efficient, professional and knowledgeable.
• There was a leadership structure in place with clear responsibilities, roles and systems of accountability to support good governance and management. Staff felt supported by the leadership team and worked well together as a team.
• The provider was aware of the requirements of the duty of candour.

We carried out an announced comprehensive inspection on 13 January 2016 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 providing well-led care in accordance with the relevant regulations.

Background

MASTA Travel Clinic – Bristol is a private clinic providing travel health advice, vaccinations and travel medicines to children and adults. The clinic has two treatment rooms that are located within a STA Travel shop. There is usually one or two clinical nursing staff running the clinic; there is a lead nurse for the clinic and two nurses who work part-time. The travel health service is available daily Monday to Saturday.

The Regional Clinic Manager (South) 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.

Six people provided feedback about the service on comment cards. Five out of six people mentioned that the environment was clean and hygienic. All six people commented that they were pleased with the service from the staff. We spoke with two people who said they were very happy with the service and that they had received good travel information.

Our key findings were:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Staff assessed people’s needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• People said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The clinic had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The clinic proactively sought feedback from staff and patients, which it acted on.

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

• Ensure that robust systems and processes are in place in respect of child safeguarding training. The provider offers nurse led consultations and must make sure that any nursing staff working on their own at the clinic have undertaken the required level of competency training for child safeguarding appropriate for the service.

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:

• Widely publicise the complaints procedure so that people know how to complain and raise concerns.
• Provide information about the availability of a chaperone to people who use the service.
• Risk assess the labelling and dispensing process to ensure that the right medicines and directions are given to people.
• Review if reasonable adjustments can be made to accommodate a more diverse population. For example, access for people with physical and sensory disabilities and people whose first language is not English.