We carried out an announced comprehensive inspection of Trailfinders Travel Clinic on 3 July 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 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.
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.
Trailfinders Travel Clinic provides private travel health services including travel immunisations in the Royal Borough of Kensington and Chelsea in London. Services are provided to both adults and children. This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of advice or treatment by a medical practitioner, including the prescribing of medicines.
We received feedback from 44 people about the service, including comment cards, all of which were positive about the service and indicated that patients were treated with kindness and respect. Staff were described as empathetic, caring, thorough and professional.
Our key findings were:
- There were arrangements in place to keep patients safeguarded from abuse.
- Some health and safety and premises risks had not been assessed and managed effectively.
- The premises were clean and hygienic; however infection control systems were not appropriately monitored.
- There were safe systems for the management of medicines.
- Staff knew how to deal with medical emergencies. Appropriate medicines and equipment were available.
- The service had systems for recording, acting on and improving when things went wrong.
- Travel health assessments and treatments were carried out in line with relevant and current evidence based guidance and standards.
- There was evidence of some quality improvement measures.
- Staff had the specialist skills and knowledge to deliver the service.
- Staff treated patients with kindness, respect, dignity and professionalism.
- The appointment system was flexible and patients were able to access appointments when they needed them.
- The service had a clear procedure for managing complaints. They took complaints and concerns seriously and responded to them appropriately to improve the quality of care.
- The leaders had the skills and capacity to deliver the service and provide high quality care.
- Staff stated they felt respected, supported and valued. They were proud to work in the service.
- There were clear governance arrangements for the running of the service, however some systems to assess risk were not in place.
- The provider was aware of and had systems to ensure compliance with the requirements of the duty of candour.
- The service asked staff and patients for feedback about the services they provided.
- There was evidence that the service had contributed to external publications within the field of travel health.
Notable practice:
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Two clinical staff were fellows and one clinical staff was a member of the Faculty of Travel Medicine, part of the Royal College of Physicians and Surgeons of Glasgow. There was evidence that one of the doctors and the lead nurse were involved in setting examination questions for the Faculty of Travel Medicine.
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The lead nurse, lead doctor and a second nurse had been directly involved with contributing to the Royal College of Nursing, Female Genital Mutilation guidance for travel health services which was published in 2016.
We identified regulations that were not being met and the provider must:
- Ensure care and treatment is provided in a safe way to patients.
There were areas where the provider could make improvements and should:
- Monitor the systems for obtaining, recording and auditing consent for care and treatment provided.
- Review and improve the use of induction checklists to ensure an effective induction process for staff.
- Review and improve the business continuity plan for the service.
- Review and improve the systems for communicating with a patient’s GP and verifying a patient’s identity.
- Review the provision of a whistleblowing policy for staff.