Sussex Travel Clinic was previously inspected on 8 & 9 March 2017 where we found in some areas the service was not providing safe, effective or well led care. We carried out an announced focused inspection on 25 October 2018 to check if the areas of concern had been addressed for the following key questions; Are services safe, effective, 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 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.

Our key findings were:

• Medicines were administered in accordance with guidelines.
• Processes were in place to safeguard clients from abuse.
• There was an effective system to manage infection prevention and control.
• There were comprehensive risk assessments in relation to safety issues, with clear action plans to ensure mitigating actions were completed.
• The provider ensured that all staff had completed training appropriate for their role.
• Leaders had established proper policies, procedures and activities to ensure safety and assured themselves that they were operating as intended.
• The service had introduced an updated consent form for treatment of minors, which included a statement regarding parental authority.
• The service was offered on a private, fee paying basis only.

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

• Review Legionella risk assessment and the actions required.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

People were complimentary about the care and treatment they had received. The provider gave people enough information in order for them to make decisions about their treatment. The provider followed a robust consent procedure with patients signing written consent forms before commencing treatment.

People told us that they were extremely happy with their treatment and the professionalism of staff. People had their individual needs assessed before commencing treatment and were given detailed information, including risks and side-effects.

The provider had appropriate measures in place with regards to obtaining, storing and disposing of medicines. Staff had the competency to handle and give medications and these were recorded appropriately for each individual person using the service.

There was a robust recruitment and selection process in place with evidence of checks being undertaken for new employees. Staff had the appropriate qualifications, skills and knowledge for their roles. Staff completed a thorough induction process followed by on-going professional development.

The provider had effective systems in place to monitor the quality of service provision through surveys and audits. The provider effectively dealt with incidents, risks and complaints. People using the service were listened to and comments were acted upon which led to improvements in the service.

People who use the service told us that they were satisfied with the care and treatment offered by the clinic.

We saw that people were treated with respect and involved and supported in decisions about their care and treatment. Treatment was carried out in a private room and there was evidence that individual needs had been assessed with patients and included in their treatment plans.

Patients were protected from abuse and staff respected their human rights. We saw evidence of consent forms for use with children and vulnerable adults who required travel vaccines.

The clinic complied with regulations for safe, secure and appropriate handling of medicines.

People who used the service were cared for by staff with the right knowledge, qualifications and skills to support people. The clinic had systems in place to monitor the quality of the service and used the views of people attending the service to make improvements.

We carried out an announced comprehensive inspection on 8 and 9 March 2018 to ask the clinic the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that in some areas this clinic not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that in some areas this clinic was not providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this clinic was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this clinic was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that in some areas of care this clinic was not 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.

Sussex Travel Clinic provides independent travel health advice, travel and non-travel vaccinations, and blood tests for antibody screening. People of all ages intending to travel abroad can seek advice regarding health risks and receive both information and necessary vaccinations and medicines. The clinic is also a registered yellow fever vaccination centre.

The service was provided by four nurses and a GP works remotely to provide medical support to the clinic. The registered manager held the International Society of Travel Medicine Certificate (ISTM) in Travel Health and was a member of the Faculty of Travel Medicine at the Royal College of Physicians and Surgeons Glasgow.

The provider is registered with the Care Quality Commission to provide the following regulated activity: Treatment of disease, disorder or injury. One of the nurses is the nominated individual who is also registered with Care Quality Commission as 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 service was offered on a private, fee paying basis only.
• The clinic had good facilities and was well equipped to treat clients and meet their needs.
• Assessments of a client’s treatment plan were thorough and followed national guidance.
• Clients received full and detailed explanations of any treatment options.
• The clinic had systems in place to identify, investigate and learn from incidents relating to the safety of clients and staff members.
• There were some processes in place to safeguard clients from abuse.
• There was no infection prevention and control policy; and there was no record of training in infection control.
• Some risk assessments had been carried out but there were not clear action plans to ensure that mitigating actions were completed.
• Staff did not always maintain the necessary skills and competence to support the needs of clients and not all staff had received training in Mental Capacity Act 2005 and the appropriate level of safeguarding for their role.
• The provider did not always ensure good governance, for example policies were not always followed or adapted to local needs and management of risk was not always sufficient.
• Medicines were not always administered in accordance with guidelines.
• The clinic encouraged and valued feedback from clients and staff.
• Feedback from clients was positive.
• The provider shared knowledge with the other clinics owned by the parent company and by attending education events and training and networking with other clinical professionals specialising in travel.

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

• Ensure care and treatment is provided in a safe way to patients.
• Ensure persons employed in the provision of the regulated activity receive the appropriate, training necessary to enable them to carry out the duties.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

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:

• Review and take action to improve confidentiality in the waiting room.