We carried out an announced comprehensive inspection on 17 October 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

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.

The provider MASTA Limited (Medical Advisory Services for Travellers Abroad) head office is based in Leeds. They operate several pharmacy and nurse-led travel clinics located throughout the United Kingdom.

For this inspection we visited the location at MASTA Travel Clinic Harrogate; based at Mowbray Square Medical Centre, Myrtle Square, Harrogate HG1 5AR. It is situated on the edge of Harrogate town centre and has good access to public transport and road links. There are car parking facilities outside the premises. Opening hours of the MASTA clinic are 8am to 4pm Monday, Tuesday, Wednesday, Friday and Saturday. Thursday opening hours are 11am to 7pm.

MASTA Travel Clinic Harrogate is located on the ground floor of a purpose-built health centre. They have access to one consulting room and a reception/client waiting area. Disabled access to the building and toilet facilities are available for clients.

The service provides pre-travel assessments, travel vaccinations and travel health advice. Consultations are charged either direct to the client or through the Yorkshire Health Network, as appropriate. Treatment and intervention charges vary, dependent upon what is provided. The clinic is also a registered Yellow Fever vaccination centre. MASTA Travel Clinic Harrogate has a service level agreement with a local federation of 12 GP practices (Yorkshire Health Network). This is to provide travel health services to the patients of those GP practices on their behalf. Some free of charge NHS travel vaccinations are available to Yorkshire Health Network patients if applicable; after risk assessment and subject to availability. At the time of our inspection approximately 80% of clients seen at the Harrogate clinic were referred via the Yorkshire Health Network of GP practices.

This service is registered with Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some 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. Occupational health related services, which MASTA Travel Clinic Harrogate may provide to clients under a contractual arrangement through their employer or government department, are exempt by law from CQC regulation. Therefore, they did not fall into the scope of our inspection.

The clinical team consists of five part-time travel health nurse advisors; all of whom are female. There is a receptionist, who is employed by the Yorkshire Health Network. The clinicians are supported by a range of departmental staff who are based at the head office in Leeds. This includes access to the general manager, medical lead and pharmacy staff.

A travel health nurse advisor at the location is the CQC 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:

• There was an open and transparent approach to safety.
• There was analysis of reported incidents and complaints which supported improvements in service delivery and customer satisfaction.
• Governance and risk management processes were comprehensive and supported the delivery of quality care. All staff had access to policies.
• There was an infection prevention and control policy and procedures were in place to reduce the risk and spread of infection. Comprehensive cleaning checklists were completed on a monthly, quarterly and annual basis.
• Vaccines, medicines and emergency equipment were safely managed. There were clear auditable trails relating to stock control.
• Staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the service.
• Consultations were comprehensive and undertaken in a professional manner.
• The service encouraged and valued feedback from patients and staff.
• There was a clear leadership structure. Members of the management and clinical teams were accessible and supportive.
• They had good links with local GP practices known as the Yorkshire Health Network.

There was an area where the provider should make improvements:

• Reassure themselves that the defibrillator they have access to is checked and in good working order.

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 Harrogate provides pre-travel assessments, travel vaccinations and travel health advice. In addition, the service holds a licence to administer yellow fever vaccines. They provide services both for private patients and NHS patients who are registered with a local federation of 12 GP practices, known as the Yorkshire Health Network.

This service is registered with the Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, 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 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At MASTA Travel Clinic Harrogate some services are provided to clients under a contractual arrangement through their employer or government department. These types of arrangements are exempt by law from CQC regulation. Therefore, they did not fall into the scope of our inspection.

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.

On the day of inspection, we had received 23 completed CQC comment cards, all of which were overwhelmingly positive. They described the service as being very good and efficient and staff as being professional, friendly, caring and informative.

During the inspection we reviewed a range of systems and processes relating to governance, service delivery and customer care.

Our key findings were:

• There were clear systems in place 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 across all their clinic locations.
• The effectiveness and appropriateness of care provided by the service, was routinely reviewed. It ensured that care and treatment was delivered according to evidence based guidance and up-to-date travel health information and advice.
• Clients received a personalised travel plan, known as a travel health brief, which contained a risk assessment, health information, including any additional health risks relating to their destinations, and an immunisation plan specific to them.
• Staff involved clients in decisions about their care and treatment. They treated clients with kindness, compassion, dignity and respect.
• There was a leadership and managerial structure in place with clear responsibilities, roles and accountability to support good governance.
• The provider was aware of the requirements of the duty of candour.
• Staff were aware of their own roles and responsibilities. They said they felt supported by leaders and managers who were accessible when appropriate.

The areas where the provider should make improvements are:

• Consider photographic identification checks for adults who have parental responsibility for children, in order to ascertain the correct identity.
• Review policies in line with their renewal dates.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care