We carried out an announced comprehensive inspection on 31 January 2019 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 in some areas this service was not providing safe care in accordance with the relevant regulations. The impact of our concerns is minor for clients using the service, in terms of the quality and safety of clinical care. The likelihood of these occurring in the future is low as they have been put right post-inspection.

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 in some areas this service was not providing well-led care in accordance with the relevant regulations. The impact of our concerns is minor for clients using the service, in terms of the quality and safety of clinical care. The likelihood of these occurring in the future is low as they have been put right post-inspection.

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 service provides travel health advice and travel vaccinations. This service had not been previously inspection by the Care Quality Commission (CQC).

The registered nurse who delivered the service based at Leeds 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.

We received 15 CQC client comment cards. Fourteen were positive regarding the information and service provided and said that staff were friendly, helpful and caring. There was one mixed comment regarding having to wait to gain access to the building.

Our key findings were:

• There were arrangements in place to keep clients safeguarded from abuse. However, a nominated safeguarding lead, who had undertaken the appropriate level of safeguarding training, had not been identified at the time of our inspection.
• There were some policies in place to support service delivery and safe care. However, not all were dated or had a recorded review date. There were some policies not in place that we would expect to see, such as those relating to chaperones, client consent or lone working.
• There was a recruitment process in place, including ensuring appropriate checks were undertaken prior to employment.
• The premises were clean, tidy and fit for purpose to deliver the service. However, an infection prevention and control lead had not been nominated at the time of our inspection.
• There were systems in place for the management of medicines and vaccines. However, it was noted that in the fridge some vaccines were stored inappropriately and there was evidence of overstocking.
• The nurse knew how to deal with medical emergencies. However, there was no emergency equipment in the clinic nor had a risk assessment been carried out in relation to the decision not to keep them on site.
• Clients’ needs were assessed and treatment delivered in line with current legislation, standards and guidance, such as National Travel Health Network and Centre (NaTHNaC) travel guidance.
• The nurse had not completed some areas of training, such as the appropriate level of safeguarding, basic immunisation, IPC, fire safety and training in the Mental Capacity Act 2005.
• Clients’ records were stored in line with the General Data Protection Regulation (GDPR). However, it was unsure on the day of inspection whether staff had received training in data protection and information governance.
• Feedback from clients was positive about the service they received. Reviews contained praiseworthy comments of the nurse who delivered the service.
• Information was submitted to NaTHNaC in line with guidance, such as that relating to yellow fever vaccinations.
• The provider showed a commitment to learning and improving the service. The majority of areas which had been raised as a concern or area of action had been addressed by the provider both during the inspection and post-inspection. We received evidence to support this.
• Evidence was provided post-inspection, before the report was written, that showed the provider had resolve the majority of the issues raised.

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

• Review and improve the stocking and storing of vaccines in the fridge.
• Review and update the training requirements for staff working in the service.
• Review and improve the scope and range of risks assessments required to support safe provision of the service.

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice