We carried out an announced comprehensive inspection on 3 May 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.

Your Travel Clinic provides independent travel health advice and medicines in south west London. Prior to our inspection patients completed CQC comment cards telling us about their experiences of using the service. Eleven people provided wholly positive feedback about the service.

Our key findings were:

• The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service learned from them and improved.
• The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Services were provided to meet the needs of patients.
• Patient feedback for the services offered was consistently positive.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

At our last inspection on 20 February 2014 we found that the provider did not have effective recruitment and selection processes in place to ensure that all relevant checks and documentary evidence were obtained before staff began work. One staff member did not have two references on file that had been verified .We also found that Disclosure and Barring Service (DBS) checks for staff had not been recently updated as required.

Although Hepatitis B immunity status for clinical staff was checked to reduce the risk of cross infection, there were no other checks that the provider carried out to ensure staff were physically and mentally capable of performing their roles.

Following the inspection the provider wrote to us and told us that they would ensure all staff working for them had two written and verified references on file. They would request DBS checks for all staff working for them by 30 May 2014 .They were also introducing questions during staff appraisal to check the physical and mental health of staff.

During our follow up inspection we found that the provider had made some improvements. DBS checks were up to date for all staff and two verified references were now on file for staff. Staff appraisals now included a discussion on staff`s health and well-being, to ensure they were physically and mentally able to do their job.

You can see our judgements on the front page of this report.

Most people that we spoke with told us that they were happy with the treatment provided and that sufficient information had been provided to enable them to give informed consent. One person told us, “the care was really good and notable points were friendly staff, clean clinic and an efficient service. I was given appropriate information including leaflets during my appointment”. Another person stated that the "service was really variable between doctors”, with the most recent appointment having been an “excellent service”. Some people also felt that improvements were required in ensuring effective communication by staff as to when and why the doctor was running late for their appointment.

We found the provider had arrangements in place for obtaining and acting in accordance with people’s consent to care and treatment. People's health and travel needs were assessed, and care was planned in a way that ensured their safety and welfare. The provider had systems in place to protect people against the risks associated the unsafe use and management of medicines. People's records were fit for purpose, securely stored and retained for an appropriate period. However, we found that appropriate checks were not always undertaken before staff began to work by the provider.